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Hotta M, Ueda K, Ikehara S, Tanigawa K, Nakayama H, Wada K, Kimura T, Ozono K, Sobue T, Iso H. Association between neonatal phototherapy and sleep: The Japan Environment and Children's Study. J Sleep Res 2023; 32:e13911. [PMID: 37105535 DOI: 10.1111/jsr.13911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023]
Abstract
This observational cohort study aimed to evaluate the association between the duration of neonatal phototherapy and sleep-and-wakefulness states at 1 month, 1.5 years, and 3 years of age. We analysed data from 77,876 infants using the Japan Environment and Children's Study, a nationwide birth cohort study. The participants were divided into three groups: no phototherapy, short phototherapy (1-24 h), and long phototherapy (>24 h). Multiple regression analysis was performed to assess the effect of phototherapy duration on infant sleep at each age after adjusting for potential risk factors. A longer duration of phototherapy was associated with a shorter sleep time over 24 h at 1 month of age (β, -0.62; SE, -0.77 to -0.47) when compared with a shorter duration of, or no, phototherapy, following the adjustment of confounding factors. Contrastingly, the short duration group, when compared with the no phototherapy group, was associated with later sleep onset (β, 0.04; SE, 0.00-0.08) and later sleep offset (β, 0.05; SE, 0.01-0.09) at 1.5 years of age. We concluded that the duration of phototherapy may be transiently associated with sleep duration in infants, as emphasised by the shortening of the total sleep time per 24 h at 1 month of age.
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Affiliation(s)
- Masashi Hotta
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Kimiko Ueda
- Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Japan
| | - Satoyo Ikehara
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Japan
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Kanami Tanigawa
- Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Japan
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Japan
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Hirofumi Nakayama
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazuko Wada
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Japan
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
| | - Hiroyasu Iso
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Japan
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, Suita, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Hotta M, Ueda K, Ikehara S, Tanigawa K, Nakayama H, Wada K, Kimura T, Ozono K, Sobue T, Iso H. Phototherapy and risk of developmental delay: the Japan Environment and Children's Study. Eur J Pediatr 2023; 182:2139-2149. [PMID: 36847872 DOI: 10.1007/s00431-022-04785-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/21/2022] [Accepted: 12/24/2022] [Indexed: 03/01/2023]
Abstract
UNLABELLED This observational cohort study aimed to examine the association between the duration of phototherapy for neonatal jaundice and the risk of developmental delay at 3 years of age using nationwide birth cohort data. Data from 76,897 infants were analyzed. We divided participants into four groups: no phototherapy, short phototherapy (1-24 h), long phototherapy (25-48 h), and very long phototherapy (> 48 h). The Japanese version of the Ages and Stages Questionnaire-3 was used to evaluate the risk of developmental delay at 3 years of age. Logistic regression analysis was performed to assess the impact of phototherapy duration on the prevalence of developmental delay. After adjustment for potential risk factors, a dose-response relationship was identified between the duration of phototherapy and Ages and Stages Questionnaire-3, and the differences were significant in four domains; odds ratio for communication delay was associated with short, long, and very long phototherapy = 1.10 (95% confidence interval 0.97-1.26), 1.32 (1.04-2.66), and 1.48 (1.11-1.98), respectively; for gross motor delay = 1.01 (0.89-1.15), 1.28 (1.03-2.58), and 1.26 (0.96-1.67); for problem solving delay = 1.13 (1.03-1.25), 1.19 (0.99-1.43), and 1.41 (1.11-1.79); and for personal social delay = 1.15 (0.99-1.32), 1.10 (0.84-1.44), and 1.84 (1.38-2.45). CONCLUSION Longer duration of phototherapy is a predictive factor for developmental delay, making it important to avoid extended periods of phototherapy. However, whether it increases the prevalence of developmental delay remains unclear. WHAT IS KNOWN • Phototherapy is a common treatment for neonatal jaundice, associated with both short-term and long-term complications. • However, an association between phototherapy and the prevalence of developmental delay has not been revealed in a large cohort study. WHAT IS NEW • We identified that a long duration of phototherapy was a predictive factor for developmental delay at 3 years of age. • However, whether a long duration of phototherapy increases the prevalence of developmental delay remains unclear.
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Affiliation(s)
- Masashi Hotta
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Kimiko Ueda
- Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Satoyo Ikehara
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kanami Tanigawa
- Maternal & Child Health Information Center, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.,Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hirofumi Nakayama
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kazuko Wada
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.,Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hiroyasu Iso
- Osaka Regional Center for Japan Environment and Children's Study (JECS), Osaka University, 1-3 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,Bureau of International Health Cooperation, National Center for Global Health and Medicine, Institute for Global Health Policy Research, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.
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Raeisi R, Eghbalian F, Hasanpour- Dehkordi A. The effects of clofibrate on neonatal jaundice: A systematic review. Int J Prev Med 2022; 13:3. [PMID: 35281975 PMCID: PMC8883667 DOI: 10.4103/ijpvm.ijpvm_407_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Neonatal jaundice is a prevalent disease that causes many complications, including kernicterus and even death. Previous studies have shown that clofibrate as an aryloxy isobutyric acid derivate can be effectively applied for the treatment of neonatal jaundice. Thus, this review was carried out to investigate the effects and mechanism of action of clofibrate on neonatal jaundice. Methods: The keywords such as “Clofibrate” in combination with “Neonatal jaundice” or “Neonatal hyperbilirubinemia” or “Newborn Jaundice” were used to search for relevant publications indexed in the Institute for Scientific Information (ISI), Scopus, PubMed, and Google Scholar databases. Finally, after reviewing the studies, 24 papers were included in this study. Results: Results showed that the processes of albumin-bound bilirubin transfer to the hepatocytes, hepatic uptake, and storage via ligandin, hepatic conjugation via uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1), conjugation into the bile via MRP2 represent the main action mechanism of clofibrate that turns it into the bilirubin conjugates and expels it from the bile. Besides, clofibrate has been shown to reduce the level of Total Serum Bilirubin (TSB) in infants even at a dosage of 25 mg/kg without leaving side effects. Conclusions: The results of this review revealed that clofibrate effectively reduces TSB in short-term usage and can even have a promising effect at the dosage of 25 mg/kg in full-term infants. Most studies have shown this property over a short period in term infants, and there is no evidence about long-term usage in this regard.
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Garg BD, Bansal A, Kabra NS. Role of Kangaroo Mother Care in the Management of Neonatal Hyperbilirubinemia in Both Term and Preterm Neonates: A Systematic Review. J Perinat Educ 2020; 29:123-133. [PMID: 32760181 PMCID: PMC7360130 DOI: 10.1891/j-pe-d-18-00043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neonatal hyperbilirubinemia (NNH) is the most common clinical sign seen in neonatal practice. Kangaroo mother care (KMC), a new strategy has been tried for the management of hyperbilirubinemia. AIMS To evaluate the role of KMC for reduction of bilirubin and duration of phototherapy in term and preterm neonates. METHOD The literature search was done for various randomized control trials by searching the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, ongoing clinical trials and abstracts of conferences. RESULTS This review included five RCTs that fulfilled inclusion criteria. Out of five trials, two trials reported a significant reduction in bilirubin and three trials reported a significant reduction in duration of phototherapy. CONCLUSION KMC may be a novel strategy in the management of NNH. However, due to small sample size and heterogeneity between the trials, the current evidence is not sufficient. Hence, large trials with adequate sample sizes are needed.
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Abdel-Aziz Ali SM, Mansour Galal S, Sror SM, Hussein O, Abd-El-Haseeb Ahmed AEHO, Hamed EA. Efficacy of oral agar in management of indirect hyperbilirubinemia in full-term neonates. J Matern Fetal Neonatal Med 2020; 35:975-980. [PMID: 32192396 DOI: 10.1080/14767058.2020.1740674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: This prospective randomized case control study aimed to investigate effect of oral agar administration in reducing total serum bilirubin (TSB) levels in full-term neonates with jaundice in comparison with control.Materials and methods: One hundred sixty full-term neonates were enrolled with TSB 10-19 mg/dl at first week of age from Assiut University Children's Hospital. Neonates were divided according to TSB into outpatient group (n = 100) (TSB 10-15 mg/dl) and admitted group (n = 60) (TSB > 15-19 mg/dl). Outpatients group were subdivided into agar group received oral agar and control group received placebo. Admitted group were subdivided into agar group received oral agar plus phototherapy combination and control group received phototherapy alone. Neonates in the agar supplementation received oral agar 600 mg/kg/day dissolved in 10 ml distilled water twice daily till TSB decreased to 7 mg/dl. Daily weight, stool frequency and side effects of treatment were observed for each group. TSB was determined pretreatment then serially every 48 h until TSB level reaching ≤7 mg/dl.Results: Agar fed was effective in lowering TSB in neonates with TSB 10-15 mg/dl. TSB percentage changes were not significantly lower in agar-fed newborn with TSB >15-19 mg/dl compared with control groups after 24 h and 7 days. Age fed shortened the time required to decrease TSB and increased stooling frequency.Conclusions: Oral agar supplemented feeding at 600 mg/kg/day is safe for full-term neonates and useful in decreasing TSB and phototherapy duration. The efficacy of phototherapy in decreasing TSB level in neonatal hyperbilirubinemia can be augmented with oral agar usage.
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Affiliation(s)
| | | | - Shaban M Sror
- Assiut Children's Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Omima Hussein
- Assiut Children's Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Enas A Hamed
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
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Monsef A, Eghbalian F, Rahimi N. Comparison of Purgative Manna Drop and Phototherapy with Phototherapy Treatment of Neonatal Jaundice: A Randomized Double-Blind Clinical Trial. Osong Public Health Res Perspect 2019; 10:152-157. [PMID: 31263664 PMCID: PMC6590883 DOI: 10.24171/j.phrp.2019.10.3.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives Herbal remedies such as purgative manna are used to treat neonatal jaundice. In this study Bilineaster drop (purgative manna) and phototherapy, and phototherapy treatment alone were compared by assessing phototherapy duration and number of days in hospital. Methods There were 150 consecutive term neonates with jaundice, weighting from 2,500 g to 4,000 g enrolled in this randomized double blind clinical trial. The neonates were randomly assigned to intervention and control groups. The control patients received only phototherapy and the intervention group underwent phototherapy treatment and purgative manna drop (5 drops per kg of body weight, 3 times a day). Direct and total measurements of bilirubin concentration in the serum were measured and the reduction in concentration of bilirubin was calculated. Results There were 28% of patients whose hospital duration following phototherapy was 2 days, for Bilineaster and phototherapy treatment this was 49.3% of patients. At 48 hours and 72 hours the reduction in the concentration of total bilirubin in the serum was statistically significantly different across groups (p < 0.05) but at 24 hours and 96 hours there were no significant differences between groups (p > 0.05). The reduction in direct bilirubin concentration in the serum was significantly different between groups at 72 hours and 96 hours (p > 0.001). Conclusion Purgative manna and phototherapy, can statistically significantly reduce total bilirubin concentration at 48 hours and 72 hours compared with phototherapy alone, and reduce the length of hospital stay for jaundiced neonates at 2 days compared with phototherapy treatment.
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Affiliation(s)
- Amirreza Monsef
- Pediatric Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Eghbalian
- Pediatric Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Neda Rahimi
- Pediatric Department, Hamadan University of Medical Sciences, Hamadan, Iran
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Garg BD, Kabra NS, Balasubramanian H. Role of massage therapy on reduction of neonatal hyperbilirubinemia in term and preterm neonates: a review of clinical trials. J Matern Fetal Neonatal Med 2017; 32:301-309. [PMID: 28870134 DOI: 10.1080/14767058.2017.1376316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neonatal hyperbilirubinemia (NNH) is one of the leading causes of admissions in nursery throughout the world. It affects approximately 2.4-15% of neonates during the first 2 weeks of life. AIMS To evaluate the role of massage therapy for reduction of NNH in both term and preterm neonates. METHOD The literature search was done for various randomized control trials (RCTs) by searching the Cochrane Library, PubMed, and EMBASE. RESULTS This review included total of 10 RCTs (two in preterm neonates and eight in term neonates) that fulfilled inclusion criteria. In most of the trials, Field massage was given. Six out of eight trials reported reduction in bilirubin levels in term neonates. However, only one trial (out of two) reported significant reduction in bilirubin levels in preterm neonates. Both trials in preterm neonates and most of the trials in term neonates (five trials) reported increased stool frequencies. CONCLUSION Role of massage therapy in the management of NNH is supported by the current evidence. However, due to limitations of the trials, current evidences are not sufficient to use massage therapy for the management of NNH in routine practice.
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Suganthi V, Das AG. Role of Saccharomyces boulardii in Reduction of Neonatal Hyperbilirubinemia. J Clin Diagn Res 2017; 10:SC12-SC15. [PMID: 28050461 DOI: 10.7860/jcdr/2016/20115.8878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 09/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Probiotics are known to reduce the severity of hyperbilirubinemia. AIM This study was done to evaluate the effect of probiotic on neonatal hyperbilirubinemia in term neonates. MATERIALS AND METHODS A total of 181 healthy term neonates after birth were divided into a control group (n=95) and a treatment group (n=86) randomly and treated with placebo and probiotic (Saccharomyces boulardii) respectively. A total of two doses were given orally in the first two consecutive days. The serum bilirubin levels were detected on day three of life. Babies were exclusively breastfed, clinical outcome was recorded. Comparison between groups was made by the non-parametric Mann-Whitney test. Analysis of Variance (ANOVA) was used to assess the quantitative variables. A p-value of <0.05 using a two-tailed test was taken as being of significance for all statistical tests. RESULTS On day 3, mean total serum bilirubin in control group among patient who has not developed clinical jaundice is 6.5mg% and in the treatment group is 5mg%. In patient with clinical jaundice, it is 13.6mg% in control group and 10.7mg% in the treatment group. The p-value was found to be <0.05 which is statistically significant. No obvious adverse reactions noted in either group. CONCLUSION Probiotics lowered the serum bilirubin level of healthy neonate with jaundice safely and significantly without any adverse reaction.
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Affiliation(s)
- V Suganthi
- Head of Department, Department of Pediatrics, Coimbatore Medical College Hospital , Coimbatore, Tamil Nadu, India
| | - A Gokul Das
- Paediatrician, Taluk Hospital , Pattambi, Kerala, India
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Minomo A, Ishima Y, Chuang VT, Suwa Y, Kragh-Hansen U, Narisoko T, Morioka H, Maruyama T, Otagiri M. Albumin domain II mutant with high bilirubin binding affinity has a great potential as serum bilirubin excretion enhancer for hyperbilirubinemia treatment. Biochim Biophys Acta Gen Subj 2013; 1830:2917-23. [DOI: 10.1016/j.bbagen.2013.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 12/14/2012] [Accepted: 01/07/2013] [Indexed: 11/24/2022]
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Cetinkursun S, Demirbag S, Cincik M, Baykal B, Gunal A. Effects of phototherapy on newborn rat testicles. INT J POLYM MATER PO 2006; 52:61-70. [PMID: 16338871 DOI: 10.1080/01485010500302089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. In the routine, phototherapy has some side effects including skin eruption, fluid loss, abdominal distention, mild hemolysis and mild thrombocytopenia. The aim of the study was to investigate the possible mutagenic and gametocidal side effects of 72 h continuous phototherapy on the rat testicle. We observed decreases in spermatogonia numbers per tubule (S/T values), tubular fertilization index (TFI) and sperm sertoli cell index (SSCI), which are the most reliable methods in estimating future fertility potential, due to sensitivity to phototherapy. The differences between study and control groups for S/T, TFI and SSCI values were statistically significant (p = 0.008, p = 0.02 and p = 0.004, respectively). There were significant differences in seminiferous tubule diameters between the control and study groups (p < 0.005), but no significant difference in DNA index values between the control (0.66 +/- 0.12) and study (0.59 +/- 0.05) groups (p > 0.05). As a conclusion, phototherapy seems to have some side effects on the newborn rat testicle. Further studies with larger groups, designed for investigation of the effects of phototherapy on seminiferous tubules, may give more beneficial results.
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Affiliation(s)
- S Cetinkursun
- Department of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey
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Koç H, Altunhan H, Dilsiz A, Kaymakçi A, Duman S, Oran B, Erkul I. Testicular changes in newborn rats exposed to phototherapy. Pediatr Dev Pathol 1999; 2:333-6. [PMID: 10347276 DOI: 10.1007/s100249900131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study we investigated the long-term effects of 72-h continuous phototherapy on the reproductive system of newborn rats. The animals' weight, fertilization rates, and number of newborn and histopathological changes in the gonads in a normal group not exposed to phototherapy and in the test animals were compared. At the age of 24 weeks there were no significant differences between the two groups, apart from the histology of the testicles of the male rats who were exposed to the phototherapy. The study group showed a significantly reduced diameter of the seminiferous tubules when compared to the controls (P < 0.001). It can be postulated that phototherapy may cause histological degenerative changes in the structure of the rat's testes, even though there were no changes in fertilization rates. Further studies are necessary to reveal the effects of phototherapy on humans and to determine the effects, if any, on fertility.
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Affiliation(s)
- H Koç
- Department of Pediatrics, Faculty of Medicine, University of Selçuk, 42080 Konya, Turkey
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Siegfried EC, Stone MS, Madison KC. Ultraviolet light burn: a cutaneous complication of visible light phototherapy of neonatal jaundice. Pediatr Dermatol 1992; 9:278-82. [PMID: 1488381 DOI: 10.1111/j.1525-1470.1992.tb00348.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Visible light phototherapy is an easily administered and effective treatment for neonatal indirect hyperbilirubinemia. Reported cutaneous side effects include transient rashes and the uncommon bronze baby syndrome. A more hazardous side effect is ultraviolet burn. Two premature infants developed phototherapy-induced erythema, one associated with a second-degree burn, after exposure to fluorescent daylight bulbs inadvertently used without Plexiglass shields, thus allowing prolonged ultraviolet A (UVA) exposure. Premature infants, especially during the first two weeks of life, may be significantly susceptible to UVA-induced erythema. Plexiglass shields should always be in place during visible light phototherapy, and nursery staff should be made aware of their purpose.
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Affiliation(s)
- E C Siegfried
- Department of Dermatology, University of Iowa, Iowa City 52242
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Cockington RA, Drew JH, Eberhard A. Outcomes following the use of rational guidelines in the management of jaundiced newborn infants. AUSTRALIAN PAEDIATRIC JOURNAL 1989; 25:346-50. [PMID: 2619638 DOI: 10.1111/j.1440-1754.1989.tb02354.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In 1975, rational guidelines for management of the jaundiced newborn infant were introduced to the Mercy Maternity Hospital, Melbourne. The guidelines were produced as four charts, each chart covering a particular birthweight range. The charts have been used widely. The effect of introduction of the charts has been examined by comparing the years 1971-74 with 1975-77. An overall decrease occurred in the use of phototherapy, without an increase in the use of exchange transfusion or in those with a serum bilirubin level above 339 mumol/L. The difference was not explained by an alteration in the spectrum of causes of jaundice. Long-term follow-up of jaundiced infants managed according to these guidelines revealed a satisfactory outcome despite a significant reduction in active treatment. The associated avoidance of potential side effects of treatment of the jaundiced newborn infant warrants consideration of the use of these charts by other neonatal units.
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Affiliation(s)
- R A Cockington
- Department of Paediatrics, Mercy Maternity Hospital, East Melbourne, Victoria, Australia
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Effects of physiologic jaundice on behavioral function in low-risk preterm infants. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 1987. [DOI: 10.1016/0193-3973(87)90020-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Felten RP. Light-induced changes in plasma tryptophan and cystine. Ann N Y Acad Sci 1985; 453:55-64. [PMID: 3865596 DOI: 10.1111/j.1749-6632.1985.tb11797.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Granati B, Largajolli G, Rubaltelli FF, Pollazzon P, Bottos M, Sartori E. Efficacy and safety of the "integral" phototherapy for neonatal hyperbilirubinemia. Results of a follow-up at 6 years of age. Clin Pediatr (Phila) 1984; 23:483-6. [PMID: 6467780 DOI: 10.1177/000992288402300905] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
One hundred and ten full-term newborns were treated with integral phototherapy (IP) in the first week of life for hyperbilirubinemia (peak bilirubin concentration, 19.5 +/- 2.8 mg/dl). IP was provided by an apparatus which irradiated the infants over the entire skin surface with four visible blue light lamps placed around the body at a mean distance of only 20 cm. The irradiance of the lamps at the skin surface was 0.350 mW/sq cm, in the wavelength range between 425 and 475 nm. The IP resulted in a 48-hour bilirubin decline rate of 0.163 mg/dl/h. After a mean exposure of 78 +/- 32 h, the mean plasma bilirubin level was 8.4 +/- 0.8 mg/dl. One hundred and ten comparable nonjaundiced infants were studied as controls. At 6 years of age, both groups of subjects were called for a follow-up concerning growth, visual, and hearing functions, and neuro-developmental status. The follow-up was completed in 81 children of the IP group (73.6%) and in 89 of the controls (80.6%). There were no significant differences in the studied parameters between the two groups. The study concludes that IP appears to be an effective and safe treatment for jaundiced infants. IP employs less radiant energy from the lamp source than the traditional apparatus, but delivers this energy to a larger skin surface area.
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Saigal S, Lunyk O, Bennett KJ, Patterson MC. Serum bilirubin levels in breast- and formula-fed infants in the first 5 days of life. CANADIAN MEDICAL ASSOCIATION JOURNAL 1982; 127:985-9. [PMID: 7139449 PMCID: PMC1862287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A prospective study was conducted in a level II maternity unit to investigate the incidence of hyperbilirubinemia in healthy, term, breast-fed and formula-fed infants. Serum bilirubin levels were determined for 176 breast-red and 164 formula-fed infants in cord blood and on days 1, 2, 3 and 5 after birth. The mean total bilirubin levels were significantly higher on each postnatal day in the breast-fed infants, as was the proportion of infants with peak levels above 12 mg/dl (205 mumol/l; 28% v. 6%). The breast-fed infants also had significantly higher proportional weight losses on each postnatal day than the formula-fed infants. However, there was no correlation between the cumulative weight loss on day 3 and bilirubin levels on the same day with either feeding regimen. None of the infants required an exchange transfusion or prolonged care in hospital for hyperbilirubinemia.
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Valkeakari T, Anttolainen I, Aurekoski H, Björkqvist SE. Follow-up study of phototreated fullterm newborns. ACTA PAEDIATRICA SCANDINAVICA 1981; 70:21-5. [PMID: 7211376 DOI: 10.1111/j.1651-2227.1981.tb07167.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A follow-up study including examinations made by a paediatrician, an ophthalmologist and a psychologist and complemented with EEG-recordings and a number of laboratory determinations was performed at the age of 3 years on 41 children who had received phototherapy during the first week of life and on 42 control children of the same age. No differences were found in growth, development, social maturity, neurological or ophthalmologic disorders, EEG-recordings or laboratory determinations between both groups. It seems unlikely that phototherapy causes any harmful longterm effects provided that the eyes are shielded.
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Hovi L, Hekali R, Siimes MA. Evidence of riboflavin depletion in breast-fed newborns and its further acceleration during treatment of hyperbilirubinemia by phototherapy. ACTA PAEDIATRICA SCANDINAVICA 1979; 68:567-70. [PMID: 463539 DOI: 10.1111/j.1651-2227.1979.tb05056.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Phototherapy in the treatment of newborns with hyperbilirubinemia, resulting in degradation of bilirubin, also appears to have other photodynamic effects on metabolism. We studied flavin adenine dinucleotide (FAD) saturation of erythrocyte glutathione reductase, which should reflect riboflavin nutritional status, in 28 healthy newborns, and followed 37 newborns with hyperbilirubinemia prior to the start of and during phototherapy. The results indicate that healthy newborns on human milk feeding, relatively poor in riboflavin, have evidence of a transient riboflavin depletion soon after birth. This effect is made more pronounced by phototherapy and partially prevented by parenteral or oral administration of moderate amounts of riboflavin.
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Lemaître B, Dreux C. Influence of light on the plasma gonadotropin concentrations in the newborn rat. EXPERIENTIA 1979; 35:556-7. [PMID: 437058 DOI: 10.1007/bf01922769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The physiological increase in plasma gonadotropin (LH and FSH) levels in newborn rats is indisputably influenced by light. Permanent illumination accentuates this increase, whereas darkness decreases it in 16-day-old female rats. In male rats of the same age, only permanent illumination was tested with the same results.
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Lemaitre BJ, Toubas PL, Dreux C, Minkowski A. Increased gonadotropin levels in newborn premature females treated by phototherapy. JOURNAL OF STEROID BIOCHEMISTRY 1979; 10:335-7. [PMID: 459496 DOI: 10.1016/0022-4731(79)90261-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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