So Yoon Choi; Ho Yeon Hwang; Yoo Rha Hong; Yu Jin Jung

doi:10.7180/kmj.2012.27.2.133

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Choi, Hwang, Hong, and Jung: Clinical Features and Factors Associated with the Frequency of Phototherapy in Premature Birth Gestation < 35 Weeks and Birth Weight ≤2,500 g

Original Article

Kosin Medical Journal

Kosin Medical Journal 2012; 27(2): 133-139.

Published online: 27 December 2012

DOI: https://doi.org/10.7180/kmj.2012.27.2.133

Clinical Features and Factors Associated with the Frequency of Phototherapy in Premature Birth Gestation < 35 Weeks and Birth Weight ≤2,500 g

So Yoon Choi¹, Ho Yeon Hwang¹, Yoo Rha Hong¹, Yu Jin Jung²

¹Department of Pediatrics, College of Medicine, Kosin University, Gospel Hospital, Busan, Korea.

²Department of Pediatrics, College of Medicine, Inje University, Haeundae Paik Hospital, Busan, Korea.

Corresponding Author: Yu Jin Jung, Department of Pediatrics, College of Medicien, Inje University, Haeundae Paik Hospital, 1435, Jwa-dong, Haeundae-gu, Busan, 612-030, Korea. TEL: +82-51-797-2000, FAX: +82-51-797-2668, hasaohjung@hanmail.net

Received 7 August 2012 Revised 22 October 2012 Accepted 25 October 2012

Abstract

Objectives

Clinical features according to the frequency of phototherapy and clinical risk factors on the number of phototherapy were investigated in premature births with gestation <35 weeks and birth weight ≤2,500 g.

Methods

The 186 infants with gestation <35 weeks and birth weight ≤2,500 g were admitted to the neonatal intensive care unit of Kosin University Gospel Hospital from March 2009 to August 2010. The 171 infants were alive and had jaundice requiring phototherapy. Phototherapy was usually started to 50-70% of the maximal bilirubin level. They were divided into two groups according to the frequency of phototherapy as single phototherapy group (group I) and multiple phototherapy group (group II). We retrospectively reviewed the medical records of all patients.

Results

The mean gestational age and birth weight of group I were 31.0±2.9 weeks and 1,596±485 g and those of group II were 31.1±2.6 weeks and 1,592±430 g. Compared with group I, albumin and Apgar score at 1 minute of group II were significantly higher and the day of peak bilirubin was also late. Duration of phototherapy in group II was statistically longer than that group I but duration of ventilator and aminophylline use for apnea was significantly shorter. The frequency of antibiotic use, incidence of bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) of group II were significantly lower than those of group I.

Conclusions

The day of peak bilirubin was late and the frequency of antibiotic use, incidence of BPD, and IVH were low in group II. The aggressive phototherapy may be considered in premature births with jaundice.

Keywords: Jaundice, Phototherapy, Premature birth

Figures and Tables

Fig. 1

Summary of preterm infants by the frequency of phototherapy

Abbreviations: GA, Gestational age; BW, Birth weight; PT, Phototherapy

Table 1

Demographic factors of preterm infants by the frequency of phototherapy (mean±SD)

Abbreviations: PROM, premature rupture of membranes; GDM, gestational diabetes mellitus; PIH, pregnancy induced hypertension.

Table 2

Clinical features of preterm infants by the frequency of phototherapy (mean±SD)

Abbreviations: PT, Phototherapy; AMP, aminophylline; TPN, total parenteral nutrition.

Table 3

Outcomes of preterm infants by the frequency of phototherapy

Abbreviations: RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; ROP, retinopathy of prematurity; BPD, bronchopulmonary dysplasia; IVH, intraventricular hemorrhage; PVL, periventricular leukomalacia.

Table 4

Logistic regression results of outcomes

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