HYPOCALCAEMIA DUE TO PHOTOTHERAPY IN TERM NEONATES WITH NEONATAL HYPERBILIRUBINEMIA

BACKGROUND Jaundice is an important problem in the first week of life. 1,2 It is a cause for concern for the physician and a source of anxiety for the parents. High bilirubin level may be toxic to the developing central nervous system and may cause neurological impairment even in term newborns.(3) Jaundice in newborn is quite common affecting nearly 60% of term and 80% of preterm neonates during first week of life. The objective of this study was to evaluate the incidence of hypocalcaemia due to phototherapy in term neonates, and symptomatic hypocalcaemia due to phototherapy. MATERIALS AND METHODS A prospective study conducted at Special Care Newborn Unit in Govt. Medical College, Kottayam. All term neonates AGA admitted for phototherapy were taken consecutively till the estimated sample size of 165 was achieved according to the inclusion and exclusion criteria. The data was obtained in a prestructured proforma. Blood samples were taken before starting phototherapy and after 48 hrs of phototherapy. Serum calcium was estimated by colorimetric method using dye Arsenazo III by AutoZyme Calcium Arsenazo III. Neonates were observed for symptoms of hypocalcaemia, and other adverse effects of phototherapy. The change in calcium level, incidence of hypocalcaemia, and symptoms of hypocalcaemia and observed adverse effects were analysed statistically. RESULTS 165 term babies meeting the inclusion and exclusion criteria were studied. 51.5% were male 48.5% were female babies. 71.5% were born by normal delivery and 28.5% were born by CS. Mean birth weight of babies were 3.02 kg. Before phototherapy, there was no statistically significant difference in calcium values between any of the groups. Statistically significant fall in serum calcium level following phototherapy was observed in the study with a p value of 0.003. Incidence of hypocalcaemia following phototherapy was found to be 26.1%. Symptomatic hypocalcaemia following phototherapy was found to be only 1.2%. CONCLUSION This study shows that phototherapy causes significant fall in serum calcium level. Incidence of hypocalcaemia due to phototherapy was found to be 26.1%. So, close monitoring of serum calcium level is warranted for babies receiving phototherapy and routine supplementation of calcium should be considered in them.