Investigating the Efficacy and Safety of Silymarin in Management of Hyperbilirubinemia in Neonatal Jaundice

Abstract

Unconjugated hyperbilirubinemia (UCB) is one of the most common conditions in neonates. Conventional treatment consists of phototherapy and exchange transfusion. Phototherapy is safe and effective but it has several disadvantages. Exchange transfusion is associated with a significant morbidity and even mortality. That indicates the need to develop an alternative pharmacological treatment strategies. It should be less invasive and at least as effective and safe as phototherapy. Herbal therapy has recently received special attention. Silymarin herbal drug has laxative, antioxidant, anti-inflammatory, hepatic protective, regenerative and enhancing of glucoronidation activities. The study presented here aimed to investigate effect of Silymarin on duration of phototherapy. A prospective cohort trial performed on 170 full term healthy neonates with UCB, 85 received oral 3.75mg/kg of Silymarin twice daily plus phototherapy and 85 neonates received only phototherapy. Total serum bilirubin (TSB) was measured every 24h, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) and albumin were measured before and after therapy for both groups. The mean duration of phototherapy was found to be significantly reduced from 5.3 ± 0.82 days in the control group to 4.2 ± 0.76 days in Silymarin-treated group (p=0.001). ALT, AST are improved to normal levels significantly (p=.001) also albumin (p=0.005). Silymarin dose of 3.75mg/kg twice daily along with phototherapy was more effective than phototherapy alone in treating full term healthy neonates with UCB.