An Observational Study of Frequency of Thrombocytopenia Following Phototheraphy in Neonatal Hyperbilirubinemia Conducted in a Tertiary Care Hospital in Maharashtra

Abstract

Background and Objective: Phototherapy is the standard treatment for neonatal hyperbilirubinemia. Although some studies have suggested an association between phototherapy and acquired thrombocytopenia during the early neonatal period, the evidence remains inconclusive. This study evaluated the frequency of thrombocytopenia following phototherapy and the factors associated with its occurrence.

Materials and Methods: This prospective observational study included 200 neonates with physiological hyperbilirubinemia admitted to the NICU of a tertiary care hospital. Phototherapy was initiated according to the American Academy of Pediatrics guidelines. Serum bilirubin and platelet counts were measured before starting phototherapy and repeated every 24 hours during treatment and immediately after its completion using an automated Coulter LH 750 analyzer, with microscopy used for confirmation. Data on sex, birth weight, gestational age, age at onset of jaundice, timing of phototherapy initiation, phototherapy dose and duration, and initial serum bilirubin levels were recorded and statistically analyzed.

Results: Among the 200 neonates studied, 70 (35%) developed thrombocytopenia following phototherapy, while 130 (65%) maintained normal platelet counts. Statistical analysis demonstrated that the observed reduction in platelet count was not significant. Furthermore, no significant association was found between thrombocytopenia and sex, birth weight, gestational age, age at onset of jaundice, timing of phototherapy initiation, phototherapy dose, duration of phototherapy, or initial serum bilirubin levels.

Conclusion: Thrombocytopenia was observed in 35% of neonates receiving phototherapy for physiological hyperbilirubinemia; however, the association was not statistically significant. Routine phototherapy does not appear to be an independent risk factor for clinically significant thrombocytopenia.