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Effect of position of infant during phototherapy in management of hyperbilirubinemia in late preterm and term neonates: a randomized controlled trial

Journal of Perinatology volume 33, pages 795–799 (2013)Cite this article

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Abstract

Objective:

To evaluate the effect of supine position when compared with periodic change of position during phototherapy in late preterm and term neonates (35 to 42 weeks) with hyperbilirubinemia on the duration of phototherapy.

Study Design:

We randomly allocated enrolled neonates with hyperbilirubinemia to either no change in position (supine group (SG); n=54) or two-hourly change of position from supine to prone and vice versa (turning group (TG); n=46). All the infants received single surface phototherapy by two dedicated compact fluorescent light units. Total serum bilirubin (TSB) was measured at the start of phototherapy and then every 12±2 h until the end of phototherapy. Phototherapy was stopped when two values were below the cut-off for age and gestational age as per the American Academy of Pediatrics Subcommittee on Hyperbilirubinemia guidelines nomogram for the management of hyperbilirubinemia in infants >35 weeks of gestation. The primary outcome was duration of phototherapy and secondary outcome was rate of fall of bilirubin within the first 24±2 h after the initiation of phototherapy.

Result:

Baseline characteristics including birth weight (g, 2752±478 vs 2748±416 P=0.96), gestation (week, 37.1±1.2 vs 37.4±1.3, P=0.26) were similar in the two groups. There was no difference in the duration of phototherapy between the SG (mean±s.d., hour, 25.5±8) and TG (mean±s.d., hour, 24.8±5), mean difference (95% confidence interval), hour, 0.7 (−2.03, 3.44, P=0.6). Rate of fall of bilirubin was also similar in both supine and turning groups with mean difference of −0.020 (95% confidence interval: −0.061, 0.021, P=0.34).

Conclusion:

Nursing babies in supine position when compared with periodic position change during phototherapy does not decrease the duration of phototherapy.

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Acknowledgements

The equipment was provided by Phoenix Medical system and Natus Medical.

Author Contributions

Dr Sainath Bhethanabhotla had primary responsibility for protocol development, patient screening, enrollment, outcome assessment and writing the manuscript. Dr Anu Thukral supervised the execution of the study and contributed to the writing of the manuscript. Dr M Jeeva Sankar and Dr Vinod Kumar Paul participated in the development of protocol and analytical framework for the study. Dr Ramesh K Agarwal participated in the development of protocol and analytical framework for the study, and performed the final data analyses. Dr Ashok K Deorari participated in the development of protocol, provided analytical framework for the study, supervised the screening and contributed to the final outcome assessment and writing the manuscript.

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Authors and Affiliations

  1. Departments of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

    S Bhethanabhotla, A Thukral, M J Sankar, R Agarwal, V K Paul & A K Deorari

Authors
  1. S Bhethanabhotla
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  2. A Thukral
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  3. M J Sankar
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  4. R Agarwal
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  5. V K Paul
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  6. A K Deorari
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Correspondence to A K Deorari.

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The authors declare no conflict of interest.

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Bhethanabhotla, S., Thukral, A., Sankar, M. et al. Effect of position of infant during phototherapy in management of hyperbilirubinemia in late preterm and term neonates: a randomized controlled trial. J Perinatol 33, 795–799 (2013). https://doi.org/10.1038/jp.2013.54

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