Side Effects of Phototherapy on Neonates

Abstract

Phototherapy in neonates for treatment of pathological jaundice is an effective therapeutic tool that is widely used in neonatal units. Over the past years, a greater concern has emerged about the effects on the immune and inflammatory system and its potential genotoxic and side effects, especially the late ones, possibly associated with childhood diseases, showing that this treatment is not as harmless as previously believed. Numerous studies assessing these possible adverse effects of phototherapy on neonates have been published over the past years. Through this review, we seek to analyze what we know about the side effects of phototherapy in the neonatal period. The main causes of jaundice, phototherapy techniques, acute and late side effects, and effects on the immune and inflammatory system were reviewed. It was concluded that phototherapy is not a treatment free of side effects and further studies need to be conducted to elucidate its harmful effects on neonates.

The Effects of Bilirubin and Lumirubin on the Differentiation of Human Pluripotent Cell-Derived Neural Stem Cells

“…Thus, our data suggested that LR has the potential to affect the polarity and identity of NSC during early human neural development. These results may be of clinical relevance, since aggressive PT is used on preterm ELBW neonates, often accompanied by serious adverse effects [10,11]. It is also well known that the processes of neurogenesis and neurodevelopment are impaired in these neonates [51], which may even be exacerbated by BR photo-oxidation products generated during PT, based on our current data.…”

“…Although PT is considered the gold standard treatment for severely jaundiced neonates, there is a surprising lack of scientific data on the biological effects of bilirubin photo-oxidation products generated during PT. Importantly, PT does not seem to be entirely safe, particularly in ELBW preterm neonates [10,11].…”

“…Additional BR photoproducts include monopyrrolic (Z-BOX A-D), dipyrrolic (propentdyopents), and tripyrrolic (biopyrrin A/B) compounds [8,9]. Although PT is generally believed to be a safe therapeutic procedure, intensive PT of extremely low birth-weight (ELBW) newborn infants has recently been reported to be associated with an increased risk of allergies, diabetes, and even cancer and overall mortality (for reviews see [10,11]). These surprising recent observations might be due to the possible negative effects of BR photoproducts on the developing newborn brain.…”

Phototherapy with probiotics supplementation therapy and phototherapy alone in neonates with jaundice: A randomized clinical trial

“…Phototherapy can change the structure of bilirubin and increase its excretion. This is currently the standard treatment for jaundice (3). The phototherapy device can have shortand long-term side effects for the baby one of which is damage to the microbial flora of the intestine.…”

Diagnosis and Treatment of Late Jaundice in Late Preterm and Term Newborns: An Integrative Literature Review / Diagnóstico E Tratamento Da Icterícia Tardia Em Recém-Nascidos Prematuros Tardios E a Termo: Uma Revisão Integrativa De Literatura

“…Phototherapy is the most used and most scientifically proven treatment in neonatal jaundice, with several means of accomplishment. However, it is not a controversial technique, since it has a high cost, can cause side effects and creates a distance between the mother and the baby 44 . On average, in physiological jaundice, the phototherapy time is 3.9 days 45 , and there is a constant search for a reduction in that time.…”