Comparison Between the Efficacy of Continuous Phototherapy and Intermittent Phototherapy in the Treatment of Neonatal Jaundice
Onkar Khandwal, Ashish Kumar Soni
Abstract
Background: Neonatal jaundice affects approximately 50% of term and 80% of preterm neonates. Phototherapy is the first line of treatment to prevent its complications. However, there is a lack of agreement regarding the optimal method of phototherapy.
Aim: To compare the efficacy of intermittent phototherapy and continuous phototherapy
Materials and Methods: After preliminary evaluation, 440 neonates born at > 35 weeks of gestational age with clinical jaundice, admitted to the SNCU, were enrolled into the study. Neonates were divided into the intermittent phototherapy and the continuous phototherapy groups with random number allocation at admission. Continuous phototherapy was done with 6-hour on and 2-hour off sessions, and intermittent phototherapy was done with 3-hour on and 6-hour off sessions. Total serum bilirubin (TSB) levels were analyzed in both the groups and compared at baseline and at 12, 24, and 36 hours.
Results: The difference in the mean TSB levels at different time points was statistically not significant for any time point between both the phototherapy groups. Even for the overall change in the TSB level after 24 hours, the difference was not statistically significant between both the groups. Overall, “inadequate response to phototherapy” was reported in 46.19% of the neonates in the continuous phototherapy group (mean of proportion with 95% CI: 0.4619, 0.3931–0.5318) and in 51.73% of the neonates in the intermittent phototherapy group (mean of proportion with 95% CI: 0.5174, 0.45080–0.5836), and the difference was statistically not significant (P = .245).
Conclusions: Intermittent phototherapy is as effective and safe as continuous phototherapy, as the rate of reduction in the TSB level over an approximately equal duration of treatment was similar in both the phototherapy groups. Intermittent phototherapy had an advantage of less interruption in the mother–neonate bonding and decreased irradiance-related side effects.
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