The Effect of Hat on Phototherapy-Induced Hypocalcemia in Icteric Newborns

Phototherapy plays a significant role in the treatment and prevention of hyperbilirubinemia in neonates. However, this treatment modality may itself result in the development of some complications. A lesser-known complication of the phototherapy is hypocalcemia. Some studies reported hypocalcemia accompanied by a decrease in serum melatonin concentration, yet this effect can be prevented by shielding the occiput. The aim of the present study was determining the prevalence of phototherapy-induced hypocalcemia and comparing its incidence between a group of neonates whose heads were covered during phototherapy and a group of neonates who received phototherapy without hat. Patients and In a randomized clinical trial, 120 icteric neonates were evaluated in two groups of 60. All of the subjects were full term and weighed more than 2500 grams. For group A routine phototherapy was done without shielding the head and the second group(B) used hats that covered occipital area. All neonates were completely normal on physical examination. Serum bilirubin and calcium was checked on arrival, 48 hours after starting phototherapy, and 24 hours after discontinuation of the treatment. Group A was considered as the control group. A comparative study was made between these groups to determine the efficacy of hat for prevention of hypocalcemia. 18 neonates(15%) developed hypocalcemia after starting phototherapy. There was a statistically significant difference between the prevalence of hypocalcemia in group A(77.77%) and group B(22.22%)(p=0.000). None of the hypocalcemic neonates was clinically symptomatic. Serum level of calcium returned to normal 24 hours after discontinuation of phototherapy in almost all hypocalcemic neonates. The study showed that covering neonate's head and occipital area during phototherapy decreases phototherapy-induced hypocalcemia.