Incidence of phototherapy-induced hypocalcemia in neonates with hyperbilirubinemia

Background: Hyperbilirubinemia is the most common clinical abnormality in newborns during the first week of life. Phototherapy is the standard treatment but may cause complications, including hypocalcemia, a lesser-known yet significant adverse effect. This study investigated the impact of phototherapy on serum calcium levels in neonates with hyperbilirubinemia. Methods: This observational study was conducted in the NICU of BYL and T.N. Medical College, Mumbai, over 12 months after ethical approval. We included 100 neonates (> 34 weeks gestational age) with hyperbilirubinemia receiving phototherapy. Serum calcium levels were measured before and after phototherapy, and neonates were monitored for clinical hypocalcemia. Data were recorded in a pre-formatted proforma and analyzed using SPSS version 27 (p <0.05 was considered statistically significant). Results: The mean age of neonates was 3±1.2 days, the mean gestational age was 37±1.2 weeks, and the mean jaundice duration was 2.8±1.10 days. Median serum calcium levels decreased significantly from 8.6 mg/dL (8.49-8.61) pre-phototherapy to 7.35 mg/dL (7.33-7.50) post-phototherapy (p <0.001). Hypocalcemia (serum calcium ≤7 mg/dL) occurred in 16% of neonates, with 60% exhibiting mild symptoms like jitteriness or irritability. Conclusion: Phototherapy significantly reduces serum calcium levels in jaundiced neonates, with a notable incidence of hypocalcemia. Clinicians should monitor calcium levels and watch for symptoms during phototherapy to prevent complications. Further studies are needed to establish preventive strategies.