LED versus daylight phototherapy at low irradiance in newborns ≥35 weeks of gestation: randomized controlled trial

ABSTRACT

Objective: To compare the decline in TSB after 24 h of LED or fluorescent phototherapy from below in breastfed neonates ≥35 weeks of gestation.

Methods: Seventy-four neonates treated with a 17-bulb blue LED were compared with 76 neonates treated with a 7-bulb daylight device in a rooming-in unit. Spectral irradiance was measured at 5 points on a 30 × 60 cm rectangle on the gel transparent mattress.

Results: TSB of 14.0 ± 1.2 mg/dL at 64 ± 15 h after birth when starting phototherapy were similar in both groups. TSB declined by 0.16 ± 0.09 in the LED versus 0.16 ± 0.08 mg/dL/hour in the daylight group after 24 h of therapy (p = 0.87). Mean irradiance (μW/cm²/nm) was 10.5 ± 0.9 (32.5 at the central, 5.9 at the superior and 3.9 for the inferior points) in the LED versus 8.7 ± 0.6 (range, 8.3 to 9.8) in the daylight group (p < 0.001). Hypothermia (<36.0 °C) was more frequent in LED than in fluorescent (23% versus 9%; p = 0.02) group.

Conclusion: LED with heterogeneous irradiance was as effective as daylight phototherapy with homogeneous irradiance; however there is a greater need for rigorous control of the room temperature (NCT01340339).

• Bilirubin
• breast feeding
• hypothermia
• neonatal hyperbilirubinemia
• neonatal jaundice

Acknowledgements

We thank Ana Elizabeth Figueiredo MD, Geisy Maria de Souza Lima MD, and Jucille do Amaral Meneses MD PhD for the research logistic management at the IMIP Rooming-in Unit.

Declaration of interest

No external funding was secured for this study and the authors report no declarations of interest. IMIP Research and Teaching Support Fund (Fundo de Apoio à Pesquisa e Ensino do IMIP – FAPE/IMIP) acquired the BR-501 bilirubin meter (Apel, Kawaguchi, Japão), and Fanem Inc. (São Paulo, Brazil) loaned two Bilitron Bed® and two Biliberço® units. FAPE-IMIP and Fanem Inc. were not involved in the study design, data analysis and interpretation, or preparation of the manuscript. Neither the participating institutions nor the authors received any reimbursement for infants enrolled in the study.