Comparison of Phototherapy Guidelines for Neonatal Jaundice in Healthy Term Newborns

ABSTRACT

PURPOSE: We hypothesized that phototherapy, if the total serum bilirubin (TSB) is > or = 14mg/dl, would decrease not only in frequency and duration, but complications due to phototherapy, such as weight loss, rash, temperature instability, feeding intolerance, and diarrhea, would decrease when compared to phototherapy TSB > or = 10mg/dl after 48 hours of life in healthy term newborns without hemolysis. METHODS: Forty healthy newborns born by cesarean section in Hanyang University Kuri Hospital from February, 1996 and March, 1996 were enrolled and randomly divided into two groups according to different guidelines of phototherapy after 48 hours of age; study group, phototherapy TSB > or = 14mg/dl and control group, phototherapy TSB > or = 10mg/dl. TSB and body weight were measured every 24 hours from 48 hours of life to 144 hours of life. Exclusion criteria included a positive Coombs test and any pathologic conditions. RESULTS: Eventually, 17 cases were enrolled to the study group and 16 cases to the controls. Ninety-four percent of all newborns were TSB > or = 7mg/dl and 82% TSB > or = 10mg/dl. Among the newborns who reached TSB > or = 10mg/dl, 44% of them were at 48 hours of life. Phototherapy was given in the study group less frequently and shorter than in the controls (6% vs. 82%, P or = 10mg/dl were significant higher in the study group compared to the controls (11.4 +/- 1.4 vs 10.1 +/- 1.7 P=0.046; 11.2 +/- 0.7 vs 8.5 +/- 2.8, P=0.028, respectivelyy). There were no significant differences in complications of phototherapy in two groups. CONCLUSION: Phototherapy if TSB > or = 14mg/dl after 48 hours of life in healty term newborns without hemolysis decreased frequency and duration of phototherapy without any risk of kernicterus compared to phototherapy if if was at TSB > or = 10mg/dl.h