Impact of Phototherapy on Serum Electrolyte Levels in Neonates Admitted to a Tertiary Care Hospital in Barabanki (Code: T0019)

Background: Neonatal jaundice affects approximately 60% of full-term newborns and is even more common among late-preterm infants. Elevated serum bilirubin levels lead to hyperbilirubinemia, primarily due to unconjugated bilirubin. Phototherapy, especially with blue light, is the primary treatment for preventing bilirubin-induced neurotoxicity. However, the effects of phototherapy on serum electrolytes in neonates remain insufficiently researched.

Aims and Objectives

Aim: To estimate and compare the alterations in serum electrolytes of healthy term and late-preterm neonates before and after phototherapy.

Objectives:

1. To evaluate changes in serum electrolytes of term neonates (>37 weeks) before and after phototherapy.
2. To compare the alterations in serum electrolytes of late-preterm neonates (34-36+6 weeks) before and after phototherapy.

Methods: This observational cross-sectional study was conducted at Dr. KNS Memorial Institute of Medical Sciences, Barabanki, Uttar Pradesh, over 12 months from January 2023 to December 2023. The study included 120 neonates requiring phototherapy for neonatal hyperbilirubinemia. Blood samples were collected before and within 24 hours after phototherapy to measure serum sodium, calcium, and potassium levels using standard laboratory techniques. Data were analyzed using SPSS version 22.0, with statistical significance set at p<0.05.

Results: The median age at the initiation of phototherapy was 36 hours. The study included 65 males (54%) and 55 females (46%). The mean birth weight was 2900 grams, and the modes of delivery were nearly equally divided between lower segment cesarean section (50%) and normal vaginal delivery (50%). Regarding gestational age, 60% were late preterm, and 40% were term neonates.

Conclusion: Phototherapy significantly decreases serum calcium levels and alters potassium levels in neonates, while sodium levels remain unaffected. These findings emphasize the importance of closely monitoring serum electrolytes during phototherapy to manage potential imbalances. The study highlights the need for electrolyte management as part of the therapeutic protocol for neonatal hyperbilirubinemia.

Keywords: Phototherapy, Serum Electrolytes, Neonates, Tertiary Care Hospital, Barabanki.