Phototherapy Induced Hypocalcemia in Icteric Newborns Attending Birat Medical College Teaching Hospital, Morang, Nepal

Abstract

INTRODUCTION: Neonatal jaundice is the single most common abnormal physical finding and the cause of morbidity in first week of life. It is commonly managed by phototherapy with its inherent complications. A lesser known side effect, but a potential complication of phototherapy is hypocalcemia. This study was done to determine the prevalence of phototherapy induced hypocalcemia in icteric newborns and to compare it between preterm and term babies.
 MATERIALS AND METHODS: This was a hospital based cross sectional study carried out in the Department of Paediatrics, Birat Medical College Teaching Hospital from 1st September 2020 to 1st March 2021. This study was performed on 201 icteric newborns (121 term and 80 preterm) who were managed with phototherapy. Serum calcium level was estimated both before initiating phototherapy and after 24 hours of continued phototherapy. All the data were recorded in a structured proforma. Data was analysed using SPSS version 16 and p -value <0.05 was considered statistically significant.
 RESULTS: Male newborns (n=133; 66.2%) outnumbered the female newborns (n=68; 33.8%). Majority of neonates were in the age group of 1-5 days (n=156; 77.6%), with mean age of 4.50± 3.39 days. 7.9% (16 out of 201) of the neonates exhibited phototherapy induced hypocalcemia. The prevalence of hypocalcemia in preterm was 10% and term neonates was 6.6%.
 CONCLUSIONS: Hypocalcemia is a significant problem in icteric newborns treated with phototherapy. Hence there is a need for close monitoring of serum calcium levels in the icteric neonates. Also the risk is greater in preterm neonates as compared to the term neonates.