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Efficacy of double versus single phototherapy in treatment of neonatal jaundice: a meta-analysis

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Abstract

To assess the efficacy of double phototherapy in managing neonatal jaundice compared to single phototherapy in infants with different birth weight and gestational age. CENTRAL, PubMed, clinicaltrials.gov, and gray literature sources were searched from date of inception of these databases till August 2019. Primary outcome was decline of total serum bilirubin (TSB) per hour. Ten studies were eligible. Our meta-analysis showed significant difference between double phototherapy versus single phototherapy in decline of TSB per hour in preterm infants (standardized mean difference [SMD] = 2.28 [0.79–3.76], p = 0.003) and a significant decrease in TSB levels at 24 h of phototherapy in infants with birth weight ≥ 1500 g (mean difference [MD] = − 61.70 μmol/L, [− 107.96, − 15.43], p = <0.001).

Conclusion: Double phototherapy is effective in reducing TSB in infants of different gestational ages and birth weights with the most important finding regarding preterm infants, who are more susceptible to kernicterus.

What is Known:

• Double phototherapy has shown to be more efficacious than single phototherapy in treating neonatal jaundice.

• Double phototherapy efficacy on neonates with different gestational ages and birth weights still remain ambiguous in treating neonatal jaundice.

What is New:

• The results of this meta-analysis show that double phototherapy is effective in reducing TSB in infants of different gestational ages and birth weights with the most important finding regarding preterm infants, who are more susceptible to kernicterus.

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Abbreviations

CI:

Confidence interval

LED:

Light-emitting diode

MD:

Mean difference

RCT:

Randomized controlled trial

SMD:

Standardized mean difference

TSB:

Total serum bilirubin

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Authors and Affiliations

  1. Department of Internal Medicine, Ziauddin University, Karachi, Pakistan

    Muhammad Abdullah Nizam, Ali Salem Lalani, Syed Asad Sibtain & Nabeel Ali Bhangar

  2. Department of Pediatrics, Ziauddin University, Karachi, Pakistan

    Abdul Salam Alvi & Muhammad Maaz Hamdani

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  1. Muhammad Abdullah Nizam
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MMH, SAS, NAB, and ASL. The first draft of the manuscript was written by MAN and ASA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Muhammad Abdullah Nizam.

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Communicated by Daniele De Luca

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Nizam, M.A., Alvi, A.S., Hamdani, M.M. et al. Efficacy of double versus single phototherapy in treatment of neonatal jaundice: a meta-analysis. Eur J Pediatr 179, 865–874 (2020). https://doi.org/10.1007/s00431-020-03583-x

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