Study of haematological parameters in neonates receiving phototherapy for neonatal hyperbilirubinemia in a tertiary hospital
Dr. Prashant Shah, Dr. Nandimalla Vinay Kumar
Background:Neonatal Hyperbilirubinemia (NH) is commonest abnormal physical finding during the first week of life. Early discharge of healthy term newborns has become a common practice, because of various reasons. Neonatal Hyperbilirubinemia (NH) is the most common cause for readmission during the early neonatal period and is a cause of concern for the parents as well as for the pediatricians. Hence appropriate management of Neonatal Hyperbilirubinemia is of paramount importance. Phototherapy plays a significant role in prevention and treatment of hyperbilirubinemia. However, this treatment modality may itself result in inherent complications. Objectives: To evaluate the hematological changes in neonates receiving phototherapy for neonatal hyperbilirubinemia. Methods: A prospective hospital based comparative study conducted on 100 eligible neonates admitted in the Neonatal Intensive Care Unit receiving phototherapy at Krishna institute of medical sciences, Karad. from December 1st 2017 to November 30th 2018. A predesigned proforma has aided the enrollment of newborns into the study according to AAP guidelines. Serum bilirubin and hematological parameters were determined before and after termination of phototherapy. The first samples were considered as controls. A comparative study was made between before and after phototherapy groups to determine the changes in hematological parameters. Results: The study group included 100 neonates that were managed with phototherapy. Male: Female ratio was 1:1.22. Incidence of low birth weight babies was 26% and preterm was 19%. Mean birth weight and gestational age was 2.82±0.3 kg and 38.4±1.5weeks respectively. Mean duration of phototherapy was 30.20±10hrs. The mean Hemoglobin was 17.15+/-0.06 and 16.78+/-0.05, mean PCV was 50.74+/-0.52 and 49.76+/-0.51, mean Retic count was 2.09+/-0.13 and 2.72+/-0.10,mean Total count was 16466.500+/163.6 and 17368+/-151.83, mean Platelet count was 2.15+/-0.28 and 1.84+/-0.01before and after phototherapy respectively. In our study there was a significant change in mean Hemoglobin, mean PCV and mean Retic count after phototherapy when compared to before phototherapy. Whereas there was no significant change in mean total counts including mean neutrophils and mean lymphocytes before and after phototherapy and also on mean platelet count after phototherapy when compared to before phototherapy. How ever there was a significant decline in mean platelet count in LBW babies when compared to normal birth weight babies. Conclusion: The study shows that there was significant effect of phototherapy on Hemoglobin, PCV and Retic count, whereas no significant effect on Total count and platelet count. However there is a significant decline in platelet count in LBW babies and they should be monitored for changes in platelet count during phototherapy.