The effectiveness of bilateral phototherapy of neonatal jaundice and the factors influencing its severity

In the recent years, neonatal jaundice has been showing a tendency toward the protracted clinical course (hyperbilirubinemia). Up to now, there are no generally accepted criteria for the pathological nature of hyperbilirubinemia. Phototherapy is the most popular method for the treatment of this pathological condition. The present study included 173 newborn infants presenting with diagnosis of neonatal jaundice. All these patients underwent the comprehensive clinical, laboratory, and instrumental examination. They were divided into two groups. The study group (n = 125) was comprised of the children given bilateral (from top and from below) phototherapy with the use of an ATF-“Svetonyanya” apparatus. The control group contained 50 newborn infants treated by means of unilateral (only from the top) phototherapy with the help of the sane apparatus. It was shown that the main factors influencing the severity of neonatal jaundice were gestosis, maternal endocrine pathology, blood group, the low Apgar score at the first minute, and the bilirubin level in umbilical blood. The rate of reduction of bilirubinemia in the study group was 25 mcmol/l per 24 hours or higher whereas it did not exceed 15 mcmol/l per 24 hours in the control group (p < 0.05). These findings provided a basis for the withdrawal of phototherapy in all the children of the study group within 48-56 hours after its initiation while the treatment of the control children continued during 72-120 hours after the onset of phototherapy. It is concluded that bilateral phototherapy increases the rate of reduction of the indirect bilirubin level and can be prescribed to the newborn children especially to those at high risk of development of neonatal jaundice.

indirect hyperbilirubinemia, newborn infants, phototherapy