Effect of ursodeoxycholic acid on indirect hyperbilirubinemia (nonhaemolytic and haemolytic) in neonates treated with phototherapy

Abstract

Background Hyperbilirubinemia is a global problem in neonates. Classic management for indirect neonatal hyperbilirubinemia includes phototherapy and exchange transfusion. Phototherapy shows disadvantages, and exchange transfusion is related to significant morbidity. Aim To assess the added role of ursodeoxycholic acid (UDCA) in reducing unconjugated hyperbilirubinemia in neonates undergoing phototherapy. Patients and methods Our randomized controlled trial was performed on neonates with hyperbilirubinemia who needed phototherapy and were admitted to the neonatal care unit at Tanta University Hospital from May 2017 to March 2019. A total of 120 neonates were randomly divided into four groups: group A (n=30), which included neonates with nonhemolytic indirect hyperbilirubinemia who received UDCA 10 mg/kg/day beside the usual phototherapy; group B (n=30), which included neonates with isoimmune hemolytic indirect hyperbilirubinemia who received UDCA 10 mg/kg/day, besides the usual phototherapy; group C (n=30), which included neonates with nonhemolytic indirect hyperbilirubinemia who received phototherapy only; and group D (n=30), which included neonates with isoimmune hemolytic indirect hyperbilirubinemia who received phototherapy only. The total serum bilirubin (TSB) was determined every 24 h till being less than 10 mg/dl. Results TSB was significantly decreased in group A compared with group C (P<0.05). However, TSB was comparable in groups B and D (P>0.05). Duration of phototherapy was significantly shorter in groups A and B compared with groups C and D (P<0.05). Conclusion UDCA shows a beneficial added role in the treatment of neonatal indirect hyperbilirubinemia, particularly in the nonhemolytic type.