Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia

Main Article Content

Carissa Lidia
I Made Kardana
Gusti Ayu Putu Nilawati
Ida Bagus Subanada
I Gusti Agung Ngurah Sugitha Adnyana
Ayu Setyorini Mestika Mayangsari


Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia.

Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy.

Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy.

Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy.

Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.

Article Details

How to Cite
Lidia C, Kardana IM, Nilawati GA, Subanada IB, Adnyana IGA, Mayangsari AS. Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia. PI [Internet]. 11Jan.2021 [cited 7Mar.2021];61(1). Available from:
Author Biographies

Ida Bagus Subanada, Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali



Ayu Setyorini Mestika Mayangsari, Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali



Received 2020-09-24
Accepted 2021-01-11
Published 2021-01-11


1. Porter ML, Dennis BL. Hyperbilirubinemia in the term newborn. Am Fam Physician. 2002;65:599-606. PMID: 11871676.
2. Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. N Engl J Med. 2001;344:581-90. DOI: 10.1056/NEJM200102223440807.
3. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114:297-306. DOI: 10.1542/peds.114.1.297.
4. Barak M, Mirzarahimi M, Eghbali M, Amani F. The effect of phototherapy duration on serum level of total calcium and 25-hydroxy vitamin D (25(OH)D) in jaundiced neonates. IJHRS. 2014;3:123-7. DOI: 10.5455/ijhrs.000000065.
5. Rozario CI, Pillai PS, Ranamol T. Effect of phototherapy on serum calcium level in term newborns. Int J Contemp Pediatr. 2017;4:1975-9. DOI:10.18203/2349-3291.ijcp20174180.
6. Agarwal R, Deorari A, Paul V, Sankar MJ, Sachdeva A. AIIMS protocols in neonatology. 2nd ed. New Delhi: Noble Vision; 2019. p. 345-8.
7. Subhashini B, Vani SAV, Das P, Niranjjan R. Adverse effects of phototherapy on calcium, magnesium and electrolytes levels in neonatal jaundice. Int J Clin Biochem Res. 2019;6:275-8. DOI: 10.18231/j.ijcbr.2019.061.
8. Arora S, Narang GS, Singh G. Serum calcium levels in preterm and term neonates on phototherapy. J Nepal Paediatr Soc. 2014;34(1):24-8. DOI: 10.3126/jnps.v34i1.9165.
9. Taheri PA, Sajjadian N, Eivazzadeh B. Prevalence of Phototherapy Induced Hypocalcemia in Term Neonate. Iran J Pediatr. 2013;23:710-1. PMID: 24910756.
10. Khan M, Malik KA, Bai R. Hypocalcemia in Jaundiced Neonates Receiving Phototherapy. Pak J Med Sci. 2016;32(6):1449-52. DOI: 10.12669/pjms.326.10849.
7.11. Cho WI, Yu HW, Chung HR, Shin CH, Yang SW, Choi CW, et al. Clinical and laboratory characteristics of neonatal hypocalcemia. Ann Pediatr Endocrinol Metab. 2015;20:86-91. DOI: 10.6065/apem.2015.20.2.86.