Intermittent versus Continuous Phototherapy for Reducing Neonatal Hyperbilirubinemia

Objective: Clinical studies comparing intermittent versus continuous phototherapy for reducing neonatal hyperbilirubinemia have produced conflicting results. This study was conducted to compare the efficacy of intermittent with continuous phototherapy.
Methods: This study was performed on 114 neonates with indirect hyperbilirubinemia. Inclusion criteria were body weight above 2000 grams, absence of other concomitant diseases, and hyperbilirubinemia neither requiring intensive phototherapy nor exceeding the range of exchange transfusion. The neonates were randomly divided into two groups. Continuous phototherapy group received phototherapy on and off for 2 hours and half an hour respectively and the intermittent phototherapy group on and off for one hour. The phototherapy units were identical and serum total bilirubin levels were measured every 12 hours after starting phototherapy.
Findings: Two groups were matched regarding weight and risk factors such as ABO and Rh incompatibility. The difference of total serum bilirubin levels between two groups was insignificant at the start of phototherapy and also after 12, 24, 36 and 48 hours (P>0.2).
Conclusion: Intermittent phototherapy defined as one hour on and one hour off is as effective as continuous phototherapy defined as 2 hours on and half an hour off, in reducing total serum bilirubin level in full term babies.

Keywords
Neonatal jaundice; Indirect hyperbilirubinemia; Phototherapy; Intermittent phototherapy; Continuous phototherapy