Efficacy of double versus single phototherapy in treatment of neonatal jaundice: a meta-analysis

Eur J Pediatr. 2020 Jun;179(6):865-874. doi: 10.1007/s00431-020-03583-x. Epub 2020 Jan 22.

Abstract

To assess the efficacy of double phototherapy in managing neonatal jaundice compared to single phototherapy in infants with different birth weight and gestational age. CENTRAL, PubMed, clinicaltrials.gov, and gray literature sources were searched from date of inception of these databases till August 2019. Primary outcome was decline of total serum bilirubin (TSB) per hour. Ten studies were eligible. Our meta-analysis showed significant difference between double phototherapy versus single phototherapy in decline of TSB per hour in preterm infants (standardized mean difference [SMD] = 2.28 [0.79-3.76], p = 0.003) and a significant decrease in TSB levels at 24 h of phototherapy in infants with birth weight ≥ 1500 g (mean difference [MD] = - 61.70 μmol/L, [- 107.96, - 15.43], p = <0.001).Conclusion: Double phototherapy is effective in reducing TSB in infants of different gestational ages and birth weights with the most important finding regarding preterm infants, who are more susceptible to kernicterus.What is Known:• Double phototherapy has shown to be more efficacious than single phototherapy in treating neonatal jaundice.• Double phototherapy efficacy on neonates with different gestational ages and birth weights still remain ambiguous in treating neonatal jaundice.What is New:• The results of this meta-analysis show that double phototherapy is effective in reducing TSB in infants of different gestational ages and birth weights with the most important finding regarding preterm infants, who are more susceptible to kernicterus.

Keywords: Double phototherapy; Meta-analysis; Neonatal jaundice; Neonatology.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Bilirubin / blood
  • Biomarkers / blood
  • Humans
  • Infant, Newborn
  • Jaundice, Neonatal / blood
  • Jaundice, Neonatal / diagnosis
  • Jaundice, Neonatal / therapy*
  • Phototherapy / methods*
  • Treatment Outcome

Substances

  • Biomarkers
  • Bilirubin