Total and ionic serum calcium levels before and after phototherapy in full term neonates

Introduction: Phototherapy is the standard treatment for neonatal jaundice bringing about tremendous physiological changes. Some recent reports have shown that phototherapy has an adverse impact on the serum electrolyte levels, including serum calcium levels.
Objective: To assess change in serum calcium levels following phototherapy in full-term neonates.
Methods: A total of 70 full term neonates having unconjugated hyperbilirubinemia were enrolled in the study. At admission serum bilirubin (total, conjugated and unconjugated) were noted. A blood sample was obtained and complete hematological assessment and serum calcium (total and ionic) level assessment was done. Hypocalcium and hypercalcemia were defined as serum total calcium levels <7 mg/dl and >11 mg/dl respectively. Duration of phototherapy was noted. Following phototherapy, a reassessment of serum bilirubin and calcium levels was done. Change in calcium levels was assessed. Data was analyzed using SPSS 21.0 software.
Results: At admission mean total, unconjugated and conjugated bilirubin levels were 14.47±4.22, 0.61±0.27 and 13.87±4.16 mg/dl respectively. A total of 23 (32.9%) required >72 hours phototherapy. Mean total and ionic calcium levels were 8.58±1.08 and 1.06±0.20 mg/dl respectively before phototherapy and 8.27±1.01 and 0.98±0.15 mg/dl respectively. There was a significant decline in total and ionic calcium levels following phototherapy.
Conclusion: Phototherapy had a significant impact on serum calcium levels in full-term neonates. Prophylactic calcium supplementation could be considered as a viable balancing strategy.