Phototherapy in Hyperbilirubinemic Neonates; Does it Affect Platelet Count?

Abstract

Objective:  To determine the effect of phototherapy on platelet count in neonates having unconjugated hyperbilirubinemia.

Patients and Methods:  This cross sectional study was conducted in the Neonatology unit of a Hospital, Faisalabad during a period of nine months i.e., January to September 2015. All the neonates having unconjugated hyperbilirubinemia and requiring phototherapy with normal initial platelet count were included in the study. Platelet count was evaluated before the start of phototherapy and then during phototherapy at 24 hrs, 48 hrs and 72 hrs interval. Platelet counts were compared after 24, 48 and 72 hours of phototherapy. P value < 0.05 was considered significant.

Results:  Total 150 newborns having unconjugated hyperbilirubinemia were included with mean age of 3.95 ± 1.71days. After 24 hours of phototherapy, about 8.1% of the patients were having severe thrombocytopenia (platelet count < 50 ×10⁹/L); this percentage rose to 18.4% after 48 hours and 33.3% after 72 hours of phototherapy. None of the patients developed clinical manifestation of bleeding. The number of patients with normal platelet count (1,50 × 10⁹/L – 400 × 10⁹/L) after 24 hours of continuous phototherapy was 50%, gradually reducing  to 38% after 48 hours and only 33% after 72 hours of completion of phototherapy(p value < 0.05).

Conclusion:  Hyperbilirubinemic neonates undergoing phototherapy had a fall in platelet count without any clinical manifestation of bleeding.