Dr. Nikitha Kadavakollu and Dr. KV Gopal
Aim: The present study was aimed to evaluate the effect of phototherapy on serum calcium levels in newborns requiring phototherapy according to AAP guidelines.
Methods: The present study was conducted at GSL MEDICAL COLLEGE AND GENERAL HOSPITAL, Rajahmundry, A.P and inborn Neonates admitted to NICU with hyperbilirubinemia who met the inclusion and exclusion criteria were included in the study. 150 neonates meeting the inclusion criteria were included in the study.
Results: In our study, 80 (53.3%) were males and 70 were females (46.7%) with M: F ratio being 1.14:1. The mean age of presentation of jaundice in the study population in hours of life was 84.17±16.69 hrs. Most of the presented neonates were 60-90 hours of life (78%) next after 90 hours of life (59%) in the study. The most common presentation was jaundice in our study (100%), followed by a refusal to feeds (12%), fever, and lethargy by (10.7%) and (6%), respectively. The mean ± SD of bilirubin was17.22±1.93mg/dl and7.75±1.44mg/dl before and after phototherapy respectively with significant p-value (<0.05).The mean ± SD of calcium was 9.09±0.66 mg/dl, and 8.63±0.80 mg/dl before and after phototherapy, respectively, and the p-value was significant (< 0.05).In our study, there was a reduction in calcium levels in 78.0% neonates, but significant fall to the hypo-calcemic range was seen only in 3 cases (2%). All three neonates were symptomatic. The chi-square/Fisher exact test with p-value being 0.0785, i.e., not significant. The decrease in calcium was not associated with or affected by the post-natal age of the neonate. The chi-square/Fisher exact test, with p-value being 0.481, i.e., not significant. The decrease in calcium was not associated with or affected by the sex of the neonate.
Conclusion: The study shows that neonates under phototherapy for unconjugated hyperbilirubinemia are at higher risk of reduction in serum calcium levels occasionally even to the hypocalcemic range and development of symptoms of hypocalcemia. Hence, babies should be closely monitored for variations in calcium and should be treated accordingly.
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