Neonatal jaundice is one of the most common problems in newborns. Effective treatment of jaundice requires therapeutic intervention with phototherapy (PT). Conventional phototherapy has been used for more than 50 years, but has been linked with adverse outcomes. Over recent years, several studies suggest fiberoptic phototherapy has been seen to be as effective as conventional phototherapy in preterm newborns with minimal adverse outcomes, however it was found to be less effective than conventional phototherapy in term neonates. These findings were attributed to the illuminated area and irradiance of the fiberoptic units used in previous studies. Our study aimed to compare the effectiveness of fiberoptic phototherapy unit with a larger illuminated area and higher irradiance to conventional phototherapy methods.
This was a randomized control trial conducted at Kilimanjaro Christian Medical Centre (KCMC). A total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia were randomized. Thirteen (13) newborns were allocated to receive fiberoptic phototherapy, 13 for blue light conventional phototherapy and 15 for white light conventional phototherapy. Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and treatment side effects. The data was evaluated with the independent t-test.
The mean overall bilirubin reduction rate (as %/h) was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124). However, white light conventional phototherapy had a significantly lower overall mean bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value < 0.001). The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy. No treatment side effects were noted in the fiberoptic phototherapy group.
The results confirm and quantify the benefits of increasing surface-area exposure and irradiance of the fiberoptic phototherapy unit. Fiberoptic phototherapy mitigates side effects caused by conventional phototherapy.
The Pan African Clinical Trial Registry, PACTR202004723570110. Registered 22nd April 2020- Retrospectively registered, http://www.pactr.org/