Phototherapy in Neonatal Jaundice

Background. Jaundice is a common problem in the neonatal period, and it is one of multiple factors found in children who die. Despite the majority of pathological jaundice public health consequences, there is no evidence on risk factors of pathological jaundice among neonates in Southwest Ethiopia. Therefore, this study aimed to identify factors associated with jaundice requiring phototherapy management in neonates admitted to the neonatal unit of a university teaching hospital in Southwest Ethiopia (Mizan-Tepi)...

BACKGROUND: Intravenous immunoglobulin G (IVIG) is used to treat blood-type incompatibility hemolytic disease of newborns (BTHDN). Although IVIG's efficacy for treating BTHDN has been challenged, as an updated systematic review suggests, IVIG could significantly reduce exchange transfusions. We conducted a mail-in questionnaire survey to ascertain actual use of IVIG for BTHDN in Japan. METHODS: The survey, conducted in 2014, included infants born between January 1, 2009, and December 31, 2013...

Phototherapy is the standard treatment for neonatal jaundice. We aimed to review the efficacy and safety of fenofibrate as an adjunct therapy. Twelve databases were searched and a systematic review and meta-analysis were conducted. Mean change (MC), mean difference (MD), and risk ratios (RR) with a 95% confidence interval (CI) were calculated using a random effects model. The GRADE approach was used to evaluate the evidence's certainty. Nine randomized trials were included. The MC of total serum bilirubin (mg/dl) (TSB) was significant at 12, 24, 36, 48 and 72 hours with respective MC (95% CI) values of -0...

Early-term neonates (with a gestational age (GA) of 37 and 0/7 weeks to 38 and 6/7 weeks) face higher morbidities, including respiratory and neurodevelopmental issues, than full-term (39 and 0/7 weeks to 40 and 6/7 weeks) infants. This study explores whether hyperbilirubinemia necessitating phototherapy also differs between these groups. A retrospective study was conducted on neonates born from January 2021-June 2022, excluding those with specific conditions. Evaluated factors included GA, birth weight, bilirubin levels, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and feeding type, with phototherapy given as per AAP guidelines...

The purpose of this research was to define the functions of MRS and ABR as predictors of bilirubin-induced neurologic dysfunction (BIND) in full-term neonates who required intervention (phototherapy and/or exchange transfusion). This prospective cohort study was done at the NICU of Tanta University Hospitals over a 2-year duration. Fifty-six full-term neonates with pathological unconjugated hyperbilirubinemia were divided according to MRS and ABR findings into 2 groups: group (1) included 26 cases with mild acute bilirubin encephalopathy (BIND-M score 1-4)...

BACKGROUND: This interventional study aimed to assess the impact of combining probiotics with phototherapy compared to using phototherapy alone on bilirubin reduction in term neonates hospitalized in neonatal wards in hospitals of western Iran. METHODS: This clinical trial study included 150 term neonates with a gestational age of 37 to 42 weeks, birth weight of more than 2500 g, and diagnosed with neonatal jaundice. Patients were equally assigned to two groups of phototherapy (wavelength 420-450 nm) with oral probiotics (PediLact drop, 10 drops daily) and phototherapy alone through a simple random sampling method...

Phototherapy converts lipophilic unconjugated bilirubin to hydrophilic bilirubin photoisomers, such as lumirubin. We comparatively used a blue light-emitting diode (LED) and a green fluorescent lamp (FL) as light sources for phototherapy of hyperbilirubinemic preterm neonates with the aim of examining potential differences in urinary lumirubin excretion between these two wavelengths. Urinary lumirubin levels were measured using a fluorescence assay with blue light exposure in the presence of the unconjugated bilirubin-inducible fluorescent protein UnaG, and denoted as urinary UnaG-bound bilirubin (UUB)/creatinine (Cr) (μg/mg Cr)...

BACKGROUND: Hyperbilirubinemia of the newborn infant is a common disease worldwide. However, recognized early and treated appropriately, it typically remains innocuous. We recently developed an early phototherapy prediction tool (EPPT) by means of machine learning (ML) utilizing just one bilirubin measurement and few clinical variables. The aim of this study is to test applicability and performance of the EPPT on a new patient cohort from a different population. MATERIALS AND METHODS: This work is a retrospective study of prospectively recorded neonatal data from infants born in 2018 in an academic hospital, Regensburg, Germany, meeting the following inclusion criteria: born with 34 completed weeks of gestation or more, at least two total serum bilirubin (TSB) measurement prior to phototherapy...

BACKGROUND: The administration of antenatal corticosteroids (ACS) is standard practice for management of threatened preterm birth. Its benefit, especially in small for gestational age (SGA) late preterm, is unclear. OBJECTIVES: To evaluate the impact of ACS on perinatal outcome of late preterm SGA neonates. METHODS: We conducted a retrospective cohort study of all women carrying a singleton gestation who had late preterm delivery (34-36 gestational weeks) of SGA neonates at a single tertiary university-affiliated medical center (July 2012-December 2017)...

IMPORTANCE: Gestational diabetes is a common complication of pregnancy and the optimal management is uncertain. OBJECTIVE: To test whether early initiation of metformin reduces insulin initiation or improves fasting hyperglycemia at gestation weeks 32 or 38. DESIGN, SETTING, AND PARTICIPANTS: Double-blind, placebo-controlled trial conducted in 2 centers in Ireland (one tertiary hospital and one smaller regional hospital). Participants were enrolled from June 2017 through September 2022 and followed up until 12 weeks' postpartum...

BACKGROUND: Although delayed cord clamping has well-known benefits for preterm and term neonates, it has been inadequately assessed in alloimmunized neonates. OBJECTIVE: To evaluate the benefits and risks of delayed cord clamping in alloimmunized neonates. STUDY DESIGN: This is a retrospective comparative pre-post cohort study conducted from 2003 to 2018 in a tertiary care center in France. Were included all living singleton neonates whose mothers were followed for red blood cell alloimmunization during gestation and confirmed at birth (N=224...

CONTEXT: Bilirubin is an important molecule, used as a marker of some liver diseases, and it can also be toxic and cause jaundice, especially in newborns. The main treatment for neonatal jaundice is phototherapy with blue light, which is still widely studied because the photophysical processes involved are not fully understood. METHODS: Calculations based on the density functional theory (DFT) at M062X/6-31G(d,p) level were performed in order to evaluate the structural, electronic, and topological properties of bilirubin isomers...

BACKGROUND: Enterohepatic bilirubin circulation is one of the determinants of neonatal jaundice. OBJECTIVE: To evaluate the role of oral zinc in reducing serum bilirubin in term neonates with hyperbilirubinemia. STUDY DESIGN: Double-blind, randomized, placebo-controlled trial. PARTICIPANTS: 106 term neonates with jaundice within the phototherapy range admitted to a level III neonatal intensive care unit. INTERVENTION: Neonates were randomized and allocated to receive either oral zinc sulfate (5 mg/day) or matching placebo for 5 days...

BACKGROUND: This nationwide survey aimed to determine the status of jaundice management in Japan. METHODS: A questionnaire about bilirubin level measurements and neonatal jaundice treatment was sent to 330 institutions providing neonatal care. The responses were analyzed according to institution level. RESULTS: Of 330 institutions, 172 responded (52.1% response rate). Total bilirubin levels were measured in the central laboratory using spectrophotometry at 134 institutions and a blood gas analyzer at 81 institutions...

OBJECTIVE: This study aims to examine the accuracy of transcutaneous bilirubin (TcB) in estimating the total serum bilirubin (TSB) level at five different sites before and immediately after phototherapy. METHODS: This study prospectively enrolled infants with a gestational age of 34 to 416/7 weeks who were clinically diagnosed with neonatal jaundice and required phototherapy within 28 days after birth. TcB levels were measured on the uncovered four areas (forehead, mid-sternum, abdomen, and interscapular site) and covered hipbone by using the Dräger JM-103 Jaundice Meter before phototherapy and at 0 min after discontinuing phototherapy...

OBJECTIVES: To determine the impact of higher bilirubin thresholds on testing and treatment of healthy infants during the neonatal period. METHODS: This quality improvement study included infants born at ≥35 weeks gestation and admitted to the well-baby nursery between July 2018 and December 2020. We assessed the transition from infants treated according to the 2004 AAP guidelines (pregroup) with those following the Northern California Neonatal Consortium guidelines (postgroup)...

OBJECTIVE: Neonatal jaundice is one of the common symptoms in the early stage of newborns, and phototherapy is a fast, safe and effective method to treat neonatal jaundice. However, recent studies have shown that phototherapy may elicit side effects on infants such as hypothermia, hyperthermia and dehydration. In order to improve the quality of phototherapy and the prognosis of patients, the changes of neonatal physiological parameters during phototherapy should be monitored to give better feed back to pediatricians or phototherapy system...

BACKGROUND: Neonatal jaundice is one of the most common physiologic problems requiring medical attention in newborns. It is benign in most cases; however, high levels of bilirubin are neurotoxic and can lead to serious brain damage. OBJECTIVES: This study aimed at assessment of magnitude of neonatal jaundice in cases of neonatal hyperbilirubinemia admitted into neonatal intensive care unit (NICU), Cairo University Pediatric Hospital and to detect possible etiologies, management and outcome...

OBJECTIVE: To determine the accuracy of transcutaneous bilirubin (TcB) to predict total serum bilirubin (TSB) in preterm infants across gestational age (GA) ranges and to calculate the cost-effectiveness of TcB as the primary screening test of choice for neonatal jaundice in neonatal intensive care unit (NICU) settings. METHODS: Single-center retrospective study of infants aged ≤ seven days admitted to the NICU over a six-month period with a paired TSB and TcB, with or without phototherapy as part of their routine clinical care...

PURPOSE: Although neonatal jaundice is a ubiquitous and predominantly benign phenomenon, the risk of neurotoxicity exists in a number of infants with unconjugated hyperbilirubinemia. Plotting bilirubin values on nomograms enables clinicians to employ an anticipatory and individualized approach with the goal of avoiding excessive hyperbilirubinemia and preventing acute bilirubin encephalopathy and its progression to kernicterus. We aimed to construct nomograms for White term infants based on transcutaneous bilirubin (TcB) measurements using a JM-105 device...