A COMPARATIVE STUDY OF RATE OF FALL OF TOTAL SERUM BILIRUBIN IN JAUNDICED BABIES FOLLOWING CONTINUOUS AND INTERMITTENT PHOTOTHERAPY

Abstract

Jaundice is observed during the first week of life in approximately 60% of term infants and 80% of preterm
infants.1 Out of the 60% only 5% term and 20% preterm actually need treatment2 like phototherapy. The
objective of the study was to calculate rate of fall of total serum bilirubin in jaundiced babies following
continuous and intermittent phototherapy. A non-randomized, group matched, prospective, experimental
study involving two comparable populations of 91 jaundiced babies receiving intermittent (45 babies - 6
hour on and 6 hour off) and continuous phototherapy (46 babies) were studied at the Tribhuvan University
Teaching Hospital over a period of six months. The percent fall of total serum bilirubin for each 24-hour on
first, second, third and fourth day of phototherapy was -9.724% (SD 25.094), 4.717% (SD 17.52), 7.468%
(SD 7.811) and 7.349% (SD 4.482) respectively in continuous phototherapy. The corresponding figures for
intermittent phototherapy were -13.623% (SD 26.804), 1.131% (SD 19.965), 7.672% (SD 15.365) and 12.864%
(SD 8.29). The differences were statistically insignificant on the first, second and third day (p=0.51, p=0.60
and p=0.95 respectively). On the fourth day it was higher with the intermittent phototherapy (p=0.04). The
total duration of photo exposure was 64.435 hours (SD 22.251) in the continuous phototherapy group as
compared to 35.581 hours (SD 12.855) in the intermittent phototherapy group (p=0.000001). In view of the
concern, which has been raised regarding the possible long-term side effects of phototherapy, intermittent
phototherapy offers an attractive therapeutic alternative by reducing the duration of light exposure to
about half without decreasing the efficacy.

Key Words: Neonatal jaundice, phototherapy.