Hypocalcemia in jaundiced neonates receiving phototherapy.

Mashal Khan,Rekha Bai,Kanwal Altaf Malik

doi:10.12669/pjms.326.10849

Abstract

Objective:To determine the frequency of hypocalcemia in term neonates with jaundice receiving phototherapy.Methods:This was a cross sectional study conducted at Neonatal intensive care unit, National Institute of Child Health, Karachi from 1st January 2014 to 30th December 2014. A total of 123 term neonates with jaundice of either gender managed by phototherapy were enrolled in the study. Gestational age was assessed through modified Ballard scoring. Duration of phototherapy was recorded. A sample of 3 ml of blood was sent to the laboratory for serum calcium level before initiating phototherapy and after 24 hours of continued phototherapy. All the data were recorded in the preformed proforma. Data was analyzed using SPSS version 19. P value <0.05 was taken as significant.Results:The mean age of the neonates was 8.35±6.74 days. Mean gestational age at the time of birth was 39.08±1.37 weeks. Mean duration of jaundice was 2.4±1.20 days. Mean duration of phototherapy was 1.74±0.98 days. Serum calcium level before and after 24 hours of initiating phototherapy was 8.73±0.68 mg/dl and 7.47±0.82mg/dl respectively Frequency of hypocalcemia in term jaundiced neonates receiving phototherapy were observed in 22.76% (28/123).Conclusions:The frequency of hypocalcemia is significant in the jaundiced neonates treated with phototherapy. One needs to be vigilant in dealing neonates in this context while serial monitoring for hypocalcemia and its complications should be considered in institutional policy and research priority.

Highlights

Jaundice is a common cause of morbidity encountered in the first week of life
Basic pathophysiology of jaundice is same in term and preterm neonates, but premature babies are at a higher risk of developing jaundice.[5]
Our study shows 22.76% (28/123) of term neonates exhibited phototherapy induced hypocalcemia

Summary

INTRODUCTION

Jaundice is a common cause of morbidity encountered in the first week of life. It is an utmost concern for the physician and a source of anxiety. Basic pathophysiology of jaundice is same in term and preterm neonates, but premature babies are at a higher risk of developing jaundice.[5] Phototherapy is the most commonly used intervention to treat and prevent severe jaundice It reduces the risk of exchange transfusion.[6] It blunts the rise of bilirubin level regardless of the etiology of jaundice.[7] Though it is considered safe, a few side effects encountered in phototherapy are loose stools, hyperthermia, dehydration due to fluid loss, skin burn, photo retinitis, low platelet count, increased red cell osmotic fragility, bronze baby syndrome, riboflavin deficiency and DNA damage. Sex, gestational age, duration of jaundice and duration of phototherapy was controlled through stratification by applying chi squared test and p-value

RESULTS

Findings

DISCUSSION

CONCLUSIONS