Comparison of Continuous with Intermittent Phototherapy in The Treatment of Physiological Jaundice in Term Neonates

Abstract

Background: Neonatal jaundice is a common condition in term neonates, and phototherapy remains the mainstay of treatment. While continuous phototherapy (CPT) is the standard, intermittent phototherapy (IPT) is being explored as a practical alternative.  Objective: To compare the reduction in serum bilirubin levels and the occurrence of side effects between continuous and intermittent phototherapy in the treatment of neonatal jaundice. Methods: A randomized controlled trial was conducted at the Department of Pediatrics, Shalamar Hospital, Lahore, including 148 term neonates aged 1–9 days with physiological jaundice. Participants were randomly assigned into two groups of 74 each: Group A received CPT (2 hours on, 20 minutes off) and Group B received IPT (1 hour on, 30 minutes off). Results: Both groups were comparable in baseline demographics and bilirubin levels. After 36 hours, Group A showed a significantly greater mean reduction in serum bilirubin (9.24 ± 0.98 mg/dL) compared to Group B (8.39 ± 0.78 mg/dL) with p = 0.003. The duration of phototherapy was shorter in Group A (38.6 ± 4.2 hours) than in Group B (42.3 ± 5.1 hours, p = 0.02). Minor side effects such as dehydration and hypothermia were slightly more frequent in the CPT group, though not statistically significant. Conclusion: It is concluded that continuous phototherapy is more effective than intermittent phototherapy in reducing bilirubin levels in term neonates and achieves the desired effect in a shorter duration. While intermittent phototherapy may be safer and more practical in some settings, continuous phototherapy remains the preferred choice, particularly in neonates with higher bilirubin levels.