Neonatal Phototherapy Adverse Effects in Infants: A Scoping Review
Main Article Content
Abstract
Objective: To determine what adverse effects of neonatal phototherapy have been identified and the general breadth of the research.
Data Sources: A search for relevant sources was conducted using PubMed, The Cochrane Database, Ovid, and Clinical Key via EBSCO Discovery Search from January 2013-January 2023.
Study Selection: Sources were included if participants had undergone phototherapy for hyperbilirubinemia during their first weeks of life, including term and preterm infants. Twenty-three sources met the inclusion criteria.
Data Extraction: Extraction included citation, design, context, aim, participants, outcomes, and main results.
Data Synthesis: General concepts leading the synthesis included adverse effects of neonatal phototherapy. In addition, specific subgroups of adverse effects explored included childhood allergies, childhood cancers, patent ductus arteriosus (PDA), migraine headaches, attention deficit hyperactivity disorder, autism spectrum disorder, eye disorders and acoustic disorders.
Conclusion: While the quality of studies varies, more rigorous research on adverse effects of neonatal phototherapy would benefit from careful selection of methods and reference standards, direct measures of each adverse outcome identified in adults and children, and prospective cohort studies linking early neonatal exposure with each adverse outcome outcomes throughout childhood and adolescence.
Elucidating the effects of hyperbilirubinemia versus neonatal phototherapy on each potential adverse outcome will help to determine if new treatment methods for infants with hyperbilirubinemia need to be developed.
Article Details
How to Cite
MENDELSON, Sherri.
Neonatal Phototherapy Adverse Effects in Infants: A Scoping Review.
Medical Research Archives, [S.l.], v. 11, n. 7.1, july 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4099>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i7.1.4099.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999;103(1):6-14. doi:10.1542/peds.103.1.6
2. Slaughter JL, Kemper AR, Newman TB. Technical Report: Diagnosis and Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2022;150(3):e2022058865. doi:10.1542/peds.2022-058865
3. Cremer RJ, Perryman PW, Richards DH. Influence of light on the hyperbilirubinaemia of infants. Lancet. 1958;1(7030):1094-1097. doi:10.1016/s0140-6736(58)91849-x
4. Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015;2015:0319. Published 2015 May 22.
5. Tsao PC, Yeh HL, Shiau YS, et al. Long-term neurodevelopmental outcomes of significant neonatal jaundice in Taiwan from 2000-2003: a nationwide, population-based cohort study. Sci Rep. 2020;10(1):11374. Published 2020 Jul 9. doi:10.1038/s41598-020-68186-w
6. Auger N, Laverdière C, Ayoub A, Lo E, Luu TM. Neonatal phototherapy and future risk of childhood cancer. Int J Cancer. 2019;145(8):2061-2069. doi:10.1002/ijc.32158
7. Jašprová J, Dal Ben M, Hurný D, et al. Neuro-inflammatory effects of photodegradative products of bilirubin. Sci Rep. 2018;8(1):7444. Published 2018 May 10. doi:10.1038/s41598-018-25684-2
8. Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-473. doi:10.7326/M18-0850
9. Hutton B, Salanti G, Caldwell DM, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):777-784. doi:10.7326/M14-2385
10. Erdeve O, Okulu E, Olukman O, et al. The Turkish Neonatal Jaundice Online Registry: A national root cause analysis. PLoS One. 2018;13(2):e0193108. Published 2018 Feb 23. doi:10.1371/journal.pone.0193108
11. Can E, Verim A, Başer E, İnan N. Auditory neuropathy in late preterm infants treated with phototherapy for hyperbilirubinemia. Int J Audiol. 2015;54(2):89-95. doi:10.3109/14992027.2014.938779
12. Das RR, Naik SS. Neonatal hyperbilirubinemia and childhood allergic diseases: a systematic review [published correction appears in Pediatr Allergy Immunol. 2021 Jan;32(1):210]. Pediatr Allergy Immunol. 2015;26(1):2-11. doi:10.1111/pai.12281
13. El-Sheikh MR, Ahmed AY, ELMashad AEM, Talaye II, El-Hawary EE. Eosinophil count and tumor necrosis factor α in response to phototherapy treatment of neonatal hyperbilirubinemia: a cross sectional study. Ital J Pediatr. 2022;48(1):103. Published 2022 Jun 20. doi:10.1186/s13052-022-01302-w
14. Faulhaber FRS, Procianoy RS, Silveira RC. Side Effects of Phototherapy on Neonates. Am J Perinatol. 2019;36(3):252-257. doi:10.1055/s-0038-1667379
15. Beken S, Aydin B, Zenciroğğlu A, et al. The effects of phototherapy on eosinophil and eosinophilic cationic protein in newborns with hyperbilirubinemia. Fetal Pediatr Pathol. 2014;33(3):151-156. doi:10.3109/15513815.2014.883456
16. Aydın B, Beken S, Zenciroğlu A, Dilli D, Okumuş N. Blood eosinophil levels in newborns with severe indirect hyperbilirubinemia treated with phototherapy. Iran J Pediatr. 2014;24(3):267-272.
17. Bhola K, Foster JP, Osborn DA. Chest shielding for prevention of a haemodynamically significant patent ductus arteriosus in preterm infants receiving phototherapy. Cochrane Database Syst Rev. 2015;2015(11):CD009816. Published 2015 Nov 3. doi:10.1002/14651858.CD009816.pub2
18. Mannan J, Amin SB. Meta-Analysis of the Effect of Chest Shielding on Preventing Patent Ductus Arteriosus in Premature Infants. Am J Perinatol. 2017;34(4):359-363. doi:10.1055/s-0036-1592079
19. Surmeli-Onay O, Yurdakok M, Karagoz T, et al. A new approach to an old hypothesis; phototherapy does not affect ductal patency via PGE2 and PGI2. J Matern Fetal Neonatal Med. 2015;28(1):16-22. doi:10.3109/14767058.2014.899575
20. Hemati Z, Keikha M, Khoshhali M, Kelishadi R. Phototherapy and risk of childhood cancer: A systematic review and meta-analysis. Journal of Neonatal Nursing. 2022;28(4):219-228. doi:10.1016/j.jnn.2022.01.007
21. Digitale JC, Chang PW, Li SX, Kuzniewicz MW, Newman TB. The effect of hospital phototherapy on early breastmilk feeding. Paediatr Perinat Epidemiol. 2021;35(6):717-725. doi:10.1111/ppe.12794
22. Sabzevari F, Sinaei R, Bahmanbijari B, Dehghan Krooki S, Dehghani A. Is neonatal phototherapy associated with a greater risk of childhood cancers?. BMC Pediatr. 2022;22(1):356. Published 2022 Jun 22. doi:10.1186/s12887-022-03412-0
23. Wei CC, Chang CH, Lin CL, Chang SN, Li TC, Kao CH. Neonatal jaundice and increased risk of attention-deficit hyperactivity disorder: a population-based cohort study. J Child Psychol Psychiatry. 2015;56(4):460-467. doi:10.1111/jcpp.12303
24. Hung TW, Tsai JD, Pan HH, Chen HJ, Liao PF, Sheu JN. Is Neonatal Hyperbilirubinemia Exposure Associated with a Risk of Autism Spectrum Disorder? A Nationwide Cohort Study. Am J Perinatol. 2021;38(12):1244-1253. doi:10.1055/s-0040-1708033
25. Lozada LE, Nylund CM, Gorman GH, Hisle-Gorman E, Erdie-Lalena CR, Kuehn D. Association of Autism Spectrum Disorders with Neonatal Hyperbilirubinemia. Glob Pediatr Health. 2015;2:2333794X15596518. Published 2015 Jul 21. doi:10.1177/2333794X15596518
26. Kara S, Yalniz-Akkaya Z, Yeniaras A, Örnek F, Bilge YD. Ocular findings on follow-up in children who received phototherapy for neonatal jaundice. J Chin Med Assoc. 2017;80(11):729-732. doi:10.1016/j.jcma.2017.08.003
27. Newman TB, Wu YW, Kuzniewicz MW, Grimes BA, McCulloch CE. Childhood Seizures After Phototherapy. Pediatrics. 2018;142(4):e20180648. doi:10.1542/peds.2018-0648
28. Lai YC, Yew YW. Neonatal Blue Light Phototherapy and Melanocytic Nevus Count in Children: A Systematic Review and Meta-Analysis of Observational Studies. Pediatr Dermatol. 2016;33(1):62-68. doi:10.1111/pde.12730
29. Oláh J, Tóth-Molnár E, Kemény L, Csoma Z. Long-term hazards of neonatal blue-light phototherapy. Br J Dermatol. 2013;169(2):243-249. doi:10.1111/bjd.12335
30. Khatab A, Ashour N, Shehata M. Effect of phototherapy on serum magnesium level in newborn with hyperbilirubinemia. Menoufia Medical Journal. 2021;34(3):1004-1008. doi:10.4103/mmj.mmj_250_20
31. Eghbalian F, Shabani S, Faradmal J, Jenabi E. Effects of Phototherapy on the Serum Magnesium Level in Neonates with Indirect Hyperbilirubinemia: A Prospective Cohort Study. Int J Pediatr. 2022;2022:5439630. Published 2022 Mar 22. doi:10.1155/2022/5439630
32. Chinnappa AL, Rudrappa S. Study of changes in serum sodium and potassium levels in term and preterm neonates following phototherapy. Int J of Contemp Peds. 2022;9;9; 793-798. doi: https://dx.doi.org/10.18203/2349-3291.ijcp20222115
33. Yablon LA, Mauskop A. Magnesium in headache. In R. Vink & M. Nechifor (Eds.), Magnesium in the Central Nervous System [internet]. University of Adelaide Press. 2011. https://www.ncbi.nlm.nih.gov/books/NBK507271/.
34. James AL, Chakraborty P, Tomlinson C, Harrison RV. Does riboflavin depletion cause auditory neuropathy spectrum disorder in at risk neonates?. Int J Pediatr Otorhinolaryngol. 2020;137:110238. doi:10.1016/j.ijporl.2020.110238
35. Sapkota NK. Effect of phototherapy on serum bilirubin and ionzed magnesium level in hyper-bilirubinemic neonates. Innovare J Medical Sciences. 2017;5;1;29-30.
2. Slaughter JL, Kemper AR, Newman TB. Technical Report: Diagnosis and Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2022;150(3):e2022058865. doi:10.1542/peds.2022-058865
3. Cremer RJ, Perryman PW, Richards DH. Influence of light on the hyperbilirubinaemia of infants. Lancet. 1958;1(7030):1094-1097. doi:10.1016/s0140-6736(58)91849-x
4. Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015;2015:0319. Published 2015 May 22.
5. Tsao PC, Yeh HL, Shiau YS, et al. Long-term neurodevelopmental outcomes of significant neonatal jaundice in Taiwan from 2000-2003: a nationwide, population-based cohort study. Sci Rep. 2020;10(1):11374. Published 2020 Jul 9. doi:10.1038/s41598-020-68186-w
6. Auger N, Laverdière C, Ayoub A, Lo E, Luu TM. Neonatal phototherapy and future risk of childhood cancer. Int J Cancer. 2019;145(8):2061-2069. doi:10.1002/ijc.32158
7. Jašprová J, Dal Ben M, Hurný D, et al. Neuro-inflammatory effects of photodegradative products of bilirubin. Sci Rep. 2018;8(1):7444. Published 2018 May 10. doi:10.1038/s41598-018-25684-2
8. Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-473. doi:10.7326/M18-0850
9. Hutton B, Salanti G, Caldwell DM, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):777-784. doi:10.7326/M14-2385
10. Erdeve O, Okulu E, Olukman O, et al. The Turkish Neonatal Jaundice Online Registry: A national root cause analysis. PLoS One. 2018;13(2):e0193108. Published 2018 Feb 23. doi:10.1371/journal.pone.0193108
11. Can E, Verim A, Başer E, İnan N. Auditory neuropathy in late preterm infants treated with phototherapy for hyperbilirubinemia. Int J Audiol. 2015;54(2):89-95. doi:10.3109/14992027.2014.938779
12. Das RR, Naik SS. Neonatal hyperbilirubinemia and childhood allergic diseases: a systematic review [published correction appears in Pediatr Allergy Immunol. 2021 Jan;32(1):210]. Pediatr Allergy Immunol. 2015;26(1):2-11. doi:10.1111/pai.12281
13. El-Sheikh MR, Ahmed AY, ELMashad AEM, Talaye II, El-Hawary EE. Eosinophil count and tumor necrosis factor α in response to phototherapy treatment of neonatal hyperbilirubinemia: a cross sectional study. Ital J Pediatr. 2022;48(1):103. Published 2022 Jun 20. doi:10.1186/s13052-022-01302-w
14. Faulhaber FRS, Procianoy RS, Silveira RC. Side Effects of Phototherapy on Neonates. Am J Perinatol. 2019;36(3):252-257. doi:10.1055/s-0038-1667379
15. Beken S, Aydin B, Zenciroğğlu A, et al. The effects of phototherapy on eosinophil and eosinophilic cationic protein in newborns with hyperbilirubinemia. Fetal Pediatr Pathol. 2014;33(3):151-156. doi:10.3109/15513815.2014.883456
16. Aydın B, Beken S, Zenciroğlu A, Dilli D, Okumuş N. Blood eosinophil levels in newborns with severe indirect hyperbilirubinemia treated with phototherapy. Iran J Pediatr. 2014;24(3):267-272.
17. Bhola K, Foster JP, Osborn DA. Chest shielding for prevention of a haemodynamically significant patent ductus arteriosus in preterm infants receiving phototherapy. Cochrane Database Syst Rev. 2015;2015(11):CD009816. Published 2015 Nov 3. doi:10.1002/14651858.CD009816.pub2
18. Mannan J, Amin SB. Meta-Analysis of the Effect of Chest Shielding on Preventing Patent Ductus Arteriosus in Premature Infants. Am J Perinatol. 2017;34(4):359-363. doi:10.1055/s-0036-1592079
19. Surmeli-Onay O, Yurdakok M, Karagoz T, et al. A new approach to an old hypothesis; phototherapy does not affect ductal patency via PGE2 and PGI2. J Matern Fetal Neonatal Med. 2015;28(1):16-22. doi:10.3109/14767058.2014.899575
20. Hemati Z, Keikha M, Khoshhali M, Kelishadi R. Phototherapy and risk of childhood cancer: A systematic review and meta-analysis. Journal of Neonatal Nursing. 2022;28(4):219-228. doi:10.1016/j.jnn.2022.01.007
21. Digitale JC, Chang PW, Li SX, Kuzniewicz MW, Newman TB. The effect of hospital phototherapy on early breastmilk feeding. Paediatr Perinat Epidemiol. 2021;35(6):717-725. doi:10.1111/ppe.12794
22. Sabzevari F, Sinaei R, Bahmanbijari B, Dehghan Krooki S, Dehghani A. Is neonatal phototherapy associated with a greater risk of childhood cancers?. BMC Pediatr. 2022;22(1):356. Published 2022 Jun 22. doi:10.1186/s12887-022-03412-0
23. Wei CC, Chang CH, Lin CL, Chang SN, Li TC, Kao CH. Neonatal jaundice and increased risk of attention-deficit hyperactivity disorder: a population-based cohort study. J Child Psychol Psychiatry. 2015;56(4):460-467. doi:10.1111/jcpp.12303
24. Hung TW, Tsai JD, Pan HH, Chen HJ, Liao PF, Sheu JN. Is Neonatal Hyperbilirubinemia Exposure Associated with a Risk of Autism Spectrum Disorder? A Nationwide Cohort Study. Am J Perinatol. 2021;38(12):1244-1253. doi:10.1055/s-0040-1708033
25. Lozada LE, Nylund CM, Gorman GH, Hisle-Gorman E, Erdie-Lalena CR, Kuehn D. Association of Autism Spectrum Disorders with Neonatal Hyperbilirubinemia. Glob Pediatr Health. 2015;2:2333794X15596518. Published 2015 Jul 21. doi:10.1177/2333794X15596518
26. Kara S, Yalniz-Akkaya Z, Yeniaras A, Örnek F, Bilge YD. Ocular findings on follow-up in children who received phototherapy for neonatal jaundice. J Chin Med Assoc. 2017;80(11):729-732. doi:10.1016/j.jcma.2017.08.003
27. Newman TB, Wu YW, Kuzniewicz MW, Grimes BA, McCulloch CE. Childhood Seizures After Phototherapy. Pediatrics. 2018;142(4):e20180648. doi:10.1542/peds.2018-0648
28. Lai YC, Yew YW. Neonatal Blue Light Phototherapy and Melanocytic Nevus Count in Children: A Systematic Review and Meta-Analysis of Observational Studies. Pediatr Dermatol. 2016;33(1):62-68. doi:10.1111/pde.12730
29. Oláh J, Tóth-Molnár E, Kemény L, Csoma Z. Long-term hazards of neonatal blue-light phototherapy. Br J Dermatol. 2013;169(2):243-249. doi:10.1111/bjd.12335
30. Khatab A, Ashour N, Shehata M. Effect of phototherapy on serum magnesium level in newborn with hyperbilirubinemia. Menoufia Medical Journal. 2021;34(3):1004-1008. doi:10.4103/mmj.mmj_250_20
31. Eghbalian F, Shabani S, Faradmal J, Jenabi E. Effects of Phototherapy on the Serum Magnesium Level in Neonates with Indirect Hyperbilirubinemia: A Prospective Cohort Study. Int J Pediatr. 2022;2022:5439630. Published 2022 Mar 22. doi:10.1155/2022/5439630
32. Chinnappa AL, Rudrappa S. Study of changes in serum sodium and potassium levels in term and preterm neonates following phototherapy. Int J of Contemp Peds. 2022;9;9; 793-798. doi: https://dx.doi.org/10.18203/2349-3291.ijcp20222115
33. Yablon LA, Mauskop A. Magnesium in headache. In R. Vink & M. Nechifor (Eds.), Magnesium in the Central Nervous System [internet]. University of Adelaide Press. 2011. https://www.ncbi.nlm.nih.gov/books/NBK507271/.
34. James AL, Chakraborty P, Tomlinson C, Harrison RV. Does riboflavin depletion cause auditory neuropathy spectrum disorder in at risk neonates?. Int J Pediatr Otorhinolaryngol. 2020;137:110238. doi:10.1016/j.ijporl.2020.110238
35. Sapkota NK. Effect of phototherapy on serum bilirubin and ionzed magnesium level in hyper-bilirubinemic neonates. Innovare J Medical Sciences. 2017;5;1;29-30.