Neonatal Care Academy

Home phototherapy for hyperbilirubinemia in term neonates—an unblinded multicentre randomized controlled trial

Reference: Pettersson, M., Eriksson, M., Albinsson, E. et al. Home phototherapy for hyperbilirubinemia in term neonates—an unblinded multicentre randomized controlled trial. Eur J Pediatr 180, 1603–1610 (2021). https://doi.org/10.1007/s00431-021-03932-4

This paper presents the first randomized controlled trial that compares home phototherapy with conventional phototherapy for newborns who fulfilled the AAP criteria for in-hospital care.
The aim of this study was to assess whether home phototherapy was feasible and safe in a cohort of otherwise healthy term-born neonates who fulfilled the criteria for in-hospital phototherapy. This was a randomized controlled trial in which term newborns with a total serum bilirubin of 18–24 mg/dL (300–400 μmol) were randomized to either home phototherapy or conventional in-hospital phototherapy. The primary outcome measurements were safety and efficacy, length of stay and the number of failed treatments. The secondary outcomes were the number of blood samples and weight gain during treatment. One hundred forty-seven patients were recruited, 69 patients randomized to conventional phototherapy and 78 to home phototherapy. The results showed that no patients needed blood exchange and only 4% of the patients allocated to home phototherapy were admitted to the hospital. The duration of phototherapy, length of stay, amount of blood tests and weight change showed no statically significant differences.
Conclusion: Home phototherapy could be a safe alternative to inpatient phototherapy for otherwise healthy newborns with hyperbilirubinemia if daily checkups and 24/7 telephone support can be provided. The parents should be informed to contact the hospital immediately if they fail to perform the treatment at home.

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May 17, 2022
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