Abstract:
ckground: Phototherapy is a routinely used treatment for neonatal hyperbilirubinemia, yet it generates reactive oxygen species, induce apoptosis, potentially influencing blood cells. Assessing changes in hematological parameters is essential to minimizes complications and enhance outcomes.
Objective: This study aimed to assess effect of phototherapy on hematological profiles and associated factors among neonates with hyperbilirubinemia.
Method: A cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from May to November 2023. 246 neonates selected by convenient sampling. Blood samples were collected before and after phototherapy. Hematological parameters analyzed by Sysmex KX-21 and bilirubin measured by Mindray BS-240 analyzer. Morphological examination utilized by microscopic examination of thin blood films stained with Wright stain. Data were entered into Epi-data (4.6.0), analyzed using SPSS (25.0), and summarized with frequencies, percentages, median, and interquartile range, presented in tables and figures. Normality of the data was checked by Kolmogorov-Smirnov tests. Paired t-test and Wilcoxon Sign Rank test was used to compare mean differences for normally distributed and skewed data, respectively. Pearson correlation, and multiple linear regression was used to measure the association. A significance level of p< 0.05 was used for statistical significance.
Result: Among neonates, 141(57.3%) were males, and the median age was 2 days. Phototherapy treatment led to significant increases in WBC and lymphocyte count, 11.02 ± 2.21 to 11.35 ± 2.60, and 3.93 ± 1.19 to 4.16 ± 1.34, respectively. However, hemoglobin and platelet count significantly decreased, 15.05 ± 3.67 to 14.55 ± 2.62, and 243.23 ± 74.78 to 239.32 ± 73.29, respectively. Other blood cell parameters were unaffected. WBC and lymphocyte showed positive association with preterm neonates and intensive phototherapy; while, WBC count showed a negative association with total bilirubin. Hemoglobin counts positively associated with total bilirubin but negatively associated with neonate age and treatment duration. Platelet count showed negative associations with low birth weight neonates, intensive phototherapy, and treatment duration. After treatment, normocytic normochromic cells increased, microcytic hypochromic anemia decreased, and abnormal RBC shapes reduced.
Conclusion: Phototherapy significantly affected key hematological parameters notably, WBC, lymphocyte, hemoglobin and platelet count. Treating neonates by intensive phototherapy affects WBC and platelet counts, meanwhile undergoing phototherapy for longer duration affects hemoglobin and platelet count. Therefore, routine monitoring of hematological parameters during phototherapy, specifically undergoing intensive and long duration phototherapy is importantt.
