Comparative Assessment of Phototherapy-induced Hypocalcemia Among Neonates With Unconjugated Hyperbilirubinemia

Abstract Background: Neonatal jaundice is a common problem worldwide, with majority of the neonates requiring no treatment. Phototherapy, which is one of the treatment modalities for neonatal jaundice, is associated with few complications including hypocalcemia. This study aims to determine the incidence of phototherapy-induced hypocalcemia among neonates with unconjugated hyperbilirubinemia. Materials and Methods: This was a prospective hospital-based comparative study conducted on 168 (term and preterm) neonates comprising 84 neonates with jaundice who required phototherapy and 84 neonates with jaundice who did not require phototherapy. The serum calcium levels of all the cases and controls, as well as the irradiance of the phototherapy-lamp, were measured using standard methods at presentation, and the serum calcium level assessments were repeated after 48 h. Results: The mean 48-h serum calcium level (mmol/L) level was significantly lower in the cases than the controls (2.11 ± 0.37 vs 2.34 ± 0.33, P = 0.001), with the overall incidence of phototherapy-induced hypocalcemia of 32%–5% among the cases and controls, respectively. Although the incidence of phototherapy-induced hypocalcemia was higher among the preterm neonates, the difference was not statistically significant. The study revealed no statistically significant association between the occurrence of phototherapy-induced hypocalcemia and the gender and post-natal age of the study participants, as well as the irradiance of the phototherapy-lamp. Conclusion: Phototherapy is associated with a significant reduction in serum calcium level among neonates. The present study revealed a high incidence of phototherapy-induced hypocalcemia among neonates with unconjugated hyperbilirubinemia. We therefore recommend serial monitoring of serum calcium level among all neonates with unconjugated hyperbilirubinemia undergoing phototherapy.