Role of Prophylactic Phototherapy in the Management of very Low Birth weight Newborns with Hyperbilirubinemia in Comparison to Therapeutic Phototherapy with their Gender

Abstract

Background: Bilirubin  associated brain damage is great in the preterm and low birth weight newborns. Phototherapy is able to control the level of bilirubin in low birth weight newborns. Objective:To show the role of prophylactic phototherapy in the management of very low birth weight newborns weighting(1-1.5)kg with hyperbilirubinemia in comparison to therapeutic method.

Patients and Methods: Across sectional study; Very low birth weight newborns weighting  (1–1.5)kg were included in the study and admitted to neonatal care unit because of their very low birth weight and family consent had taken about admission and prophylactic phototherapy from some families so the total number of newborns was forty, twenty newborns were received phototherapy within nine hours of birth and lasted for seven days while twenty newborns were received phototherapy when indicated according to birth weight and continued to  seventh day after birth , analysis was made for mean daily bilirubin  level , duration of phototherapy , peak bilirubin level in the prophylactic and therapeutic groups and blood exchange need.

Results: The highest daily mean level of Total Serum Bilirubin(TSB) of prophylactic group was 6.5±0.4 mg/dl, which happened on the fifth day. In the therapeutic group, it was 8.7±0.5 mg/dl on the fifth day after birth. There was significant difference in the TSB values of prophylactic group which was less than that of therapeutic group from second to sixth days( p<0.0001). The median duration of phototherapy in the treatment group was shorter than that of the prophylactic group.

Conclusion: Prophylactic  phototherapy  in very low birth weight preterm infants weighting (1-1.5) kg can significantly decrease jaundice after birth compared with the therapeutic group, also this study indicate that there is significant high TSB level among males in both groups in comparison to females.