TO STUDY THE IMPACT OF HEAD COVERING ON THE INCIDENCE OF PHOTOTHERAPY-INDUCED HYPOCALCAEMIA IN TERM NEONATES WITH HYPERBILIRUBINEMIA

Jadav Sunilkumar*

ABSTRACT

Introduction: The use of head covering during phototherapy has been suggested as a way to prevent heat loss and increase the effectiveness of treatment, but its impact on the incidence of phototherapy-induced hypocalcaemia remains unclear. Therefore, this study aims to investigate the effect of head covering on the incidence of phototherapy-induced hypocalcaemia in term neonates with hyperbilirubinemia. Materials and Methods: The neonates were randomly assigned into two groups. Study Group: Neonates receiving phototherapy while wearing a cap to cover their heads. Control Group: Neonates receiving phototherapy without any head covering. Serum calcium levels were measured for all neonates at two time points, Before the initiation of phototherapy and Post-Therapy: After 48 hours of phototherapy. The duration of phototherapy was standardized for both groups, ensuring uniform exposure. The randomization of cases minimized selection bias, and the findings aimed to provide evidence on the efficacy of head covering as a preventive measure for phototherapy-induced hypocalcemia. Results: The study analysed 160 term neonates with hyperbilirubinemia undergoing phototherapy, divided into two groups: with head covering (study group) and without head covering (control group). The baseline characteristics, including gender, gestational age, birth weight, maternal thyroid status, baby blood group and mode of delivery, were comparable between the groups. However, the baseline serum calcium levels were significantly higher in the study group compared to the control group. After 48 hours of phototherapy, both groups experienced a significant reduction in serum calcium levels, but the reduction was less pronounced in the study group (8.80 ± 1.01 mg/dL) than in the control group (8.13 ± 1.09 mg/dL), with a statistically significant difference (p < 0.001). While serum bilirubin levels significantly decreased in both groups, there was no significant difference in the extent of bilirubin reduction between the groups. These results suggest that head covering during phototherapy may help reduce the risk of phototherapy-induced hypocalcemia without affecting bilirubin clearance. Conclusion: This study highlights the protective effect of head covering in reducing phototherapy-induced hypocalcemia in term neonates with hyperbilirubinemia. While phototherapy effectively reduces serum bilirubin levels, it poses a risk of hypocalcemia due to melatonin suppression. The findings demonstrate that neonates with head covering experienced significantly smaller reductions in serum calcium levels compared to those without head covering, indicating a potential role in maintaining calcium homeostasis.

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