A Prospective Observational Study on the Appraisal of Common Cause and Efficacy of Continuous Phototherapy in Patients with Neonatal Jaundice

Abstract

Background: Neonatal jaundice is generally harmless, but high concentrations of unconjugated bilirubin may rarely cause kernicterus. Hyperbilirubinemia is the most common cause of neonatal readmission to the hospital, in the majority of cases. Aims: The study aims to determine incidence rate of neonatal jaundice as well as evaluate the commonest cause and determine the efficacy of continuous phototherapy. Study Design: A Prospective observational study. Place and Duration of Study: The study was conducted in Avis Ankura hospital for women and children. It is a well-recognized, authorized hospital where obstetrics and neonatal care is provided. The study was conducted between October 2018 to March 2019. Methodology: The study was conducted in Avis Ankura hospital for women and children. It is a well-recognized, authorized hospital where obstetrics and neonatal care is provided. A total of 162 neonates were considered. Informed consent was obtained from all the subject’s care takers. Subjects enrolled in the study were admitted in NICUs’. This study appraises the conventional cause of NNJ, evaluates the efficacy of continuous phototherapy and detects the phototherapy induced adverse reactions by using Naranjo’s causality assessment scale. Results: Among 162 patients, 94 patients (58%) were found to be males and 68 patients (42%) were found to be females. Low birth weight neonates (43.20%) were found to be more prone to neonatal jaundices. In this study, it was found that duration of phototherapy was longer in extremely low birth weight neonates (34 hours) in relation to birth weight and average duration of phototherapy. Based on the conventional cause, physiological cause (56.79%) was observed to be highest among other causes of neonatal jaundice. The short term adverse reactions due to phototherapy were identified using Naranjo’s Causality Assessment Scale. The TSB levels were increased before phototherapy (pre- treatment) and decreased after phototherapies (post-treatment) which were assessed by using American Academy of Pediatrics guidelines. Conclusion: From this study, it was concluded that males were more prone to develop neonatal jaundice when compared with females. Physiological jaundice contributes majority of cases   among the total cases. The use of phototherapy was inversely related to gestational age and birth weight.