The Effect of Phototherapy on Serum Calcium Level in Term Neonates With Jaundice at Kenyatta National Hospital - a Prospective Observational Study

Abstract

Background: Jaundice in neonates occurs when the bilirubin level rises above 85μmol/L, and it is common in more than half of term neonates. Phototherapy is a common intervention for neonates with jaundice. However, phototherapy has been associated with complications such as hypocalcaemia. The purpose of the study: The prevalence of phototherapy-induced hypocalcaemia among term neonates with jaundice on phototherapy after 48 hours at Kenyatta National Hospital. Materials and methods: This study was a prospective observational study. A consecutive sampling technique was used to recruit 91 Newborns. Data collection was done using a data a standardized questionnaire. Data analysis: Both descriptive and inferential data analysis were performed. A Paired sample t-test was used to compare serum calcium and bilirubin levels before and after phototherapy. Binary logistic regression was done to investigate factors associated with hypocalcaemia after phototherapy. Data was analyzed using Statistical Package for Social Sciences (SPSS version 26). The level of significance was evaluated at p<0.05. Results: The prevalence of hypocalcaemia after phototherapy was 19.8%, 95%CI: 12.2% - 29.5%. There was statistically significant difference between serum calcium levels before (M = 2.27, SD±0.2) mmol/l and after phototherapy (M = 2.14, SD±0.22) mmol/l, t (90) =6.355, p<0.001. There was also significant difference in bilirubin levels before (M = 314.14, SD±65.57) μmol/L and after phototherapy (M = 179.0, SD±42.69), t (90) = 22.71, p<0.001. Multivariable analysis revealed that, less than four visits (AOR =8.91, 95%CI:2.01 – 23.11, p=0.006), female neonate (AOR =15.01, 95%CI:5.01 – 39.11, p =0.004), and referral status (AOR =13.11, 95%CI:4.01 – 23.11, p =0.002) were independent factors associated with hypocalcaemia after phototherapy. Conclusion and recommendations: The findings have established that there was significant reduction in serum calcium level and bilirubin levels after phototherapy although <4 ANC visits, female neonates and referral status were found to be associated