Phototherapy in Hyperbilirubinemic Neonates; Does it Affect Platelet Count?

Abstract

<p><strong>Objective:</strong><strong>  </strong>To determine the effect of phototherapy on platelet count in neonates having unconjugated hyperbilirubinemia.</p><p><strong>Patients and Methods:</strong><strong>  </strong>This cross sectional study was conducted in the Neonatology unit of a Hospital, Faisalabad during a period of nine months i.e., January to September 2015. All the neonates having unconjugated hyperbilirubinemia and requiring phototherapy with normal initial platelet count were included in the study. Platelet count was evaluated before the start of phototherapy and then during phototherapy at 24 hrs, 48 hrs and 72 hrs interval. Platelet counts were compared after 24, 48 and 72 hours of phototherapy. P value < 0.05 was considered significant.</p><p><strong>Results:</strong><strong>  </strong>Total 150 newborns having unconjugated hyperbilirubinemia were included with mean age of 3.95 ± 1.71days. After 24 hours of phototherapy, about 8.1% of the patients were having severe thrombocytopenia (platelet count < 50 ×10<sup>9</sup>/L); this percentage rose to 18.4% after 48 hours and 33.3% after 72 hours of phototherapy. None of the patients developed clinical manifestation of bleeding. The number of patients with normal platelet count (1,50 × 10<sup>9</sup>/L – 400 × 10<sup>9</sup>/L) after 24 hours of continuous phototherapy was 50%, gradually reducing  to 38% after 48 hours and only 33% after 72 hours of completion of phototherapy(p value < 0.05).</p><p><strong>Conclusion:</strong><strong>  </strong>Hyperbilirubinemic neonates undergoing phototherapy had a fall in platelet count without any clinical manifestation of bleeding.</p><p> </p>

Phototherapy in full term neonates suffering from unconjugated hyperbilirubinemia; Does it affect platelet count?

“…This finding is in contrast to present and previous studies. [2][3][4][5]8,10 They further reported that the most significant decline in platelet counts was in 24 hours PT duration compared to the 48 hours this finding is strongly supportive to the present study as it has noted similar observations. Pishva et al 14 reported very high incidence of 49.5% of thrombocytopenia of total 101 neonates after PT.…”

“…This is in accordance to the previous studies. [2][3][4][5]8,10 Venaktamurthy et al 10 reported similar observations of platelet counts. They reported a decline in platelet counts in total study population after PT, but the difference was non-significant except in low birth babies.…”

“…Prevalence of NH is approximately 60% in full term neonates and 80% in pre-term neonates. 1,2 Full term neonates show serum bilirubin ≥12.9 mg%. Majority of term neonates shows serum bilirubin ≥ 15 mg% that has been reported in 3% cases.…”

“…It penetrates into cells in particular the neuronal tissue causing neurotoxicity. 2 Indirect bilirubin produces encephalopathy, neuronal damage leading subsequently to kernicterus. The kernicterus manifests as devastating permanent brain injury leading eventually to permanent brain retardation.…”

Características e efeitos da fototerapia em recém-nascidos: revisão integrativa

“…Também foi decaindo o número de recém-nascidos que não apresentavam nenhum grau de trombocitopenia, por volta de 50%, atingindo cerca de 33% dos pacientes. É importante salientar que nenhum recémnascido apresentou sintomas da baixa contagem de plaquetas (Sajid, et al;. Esses estudos também reforçam a ideia de que a fototerapia influencia no sistema imunológico do recém-nascido (Zarkesh, et.…”