PEDIATRICS Vol. 75 No. 2 February 1985, pp. 407-441
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Phototherapy for Hyperbilirubinemia of Hemolytic Disease of the Newborn

Harold M. Maurer MD1, Barry V. Kirkpatrick MD1, Nancy B. McWilliams MD1, David A. Draper MD1, and Dolores A. Bryla MPH1

1 From the Department of Pediatrics, Medical College of Virginia, Virginia Commonwealth University, Richmond; and Biometry Branch, Epidemiology and Biometry Research Program, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland

Although phototherapy has proven effective in lowering the serum bilirubin concentration of fullterm and premature infants with physiologic or idiopathic hyperbilirubinemia, its effect on serum bilirubin concentration in hemolytic disease due to ABO blood group incompatibility remains uncertain. Sisson and associates91 have reported a marked effect of phototherapy on serum bilirubin levels and exchange transfusion rates in premature and full-term infants with ABO incompatibility. Others have reported similar findings, but studies were retrospective49 or uncontrolled.80 On the other hand, Patel and associates79 found no significant clinical response to phototherapy in five infants (four with birth weight >2,500 g) with ABO and one infant (birth weight 2,660 g) with Rh incompatibility.

A total of 1,339 infants were randomly selected for study between May 1974 and June 1976. Of the 1,339 infants, 79.4% weighed less than 2,500 g and 276 (20.6%) were 2,500 g or more at birth. Of the 1,063 infants who weighed less than 2,500 g, 17 had positive findings on Coombs tests, 14 due to ABO incompatibility and three due to Rh incompatibility. As phototherapy was administered early and prophylactically in infants weighing less than 2,000 g and late and therapeutically in infants weighing between 2,000 and 2,499 g, a combined analysis of the infants weighing less than 2,500 g and who had positive results on Coombs test was not possible.

Of the 276 infants whose birth weight was 2,500 g or more, 64 (23.1%) had positive findings on Coombs tests, 58 due to ABO incompatibility and six to Rh incompatibility.




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S. Ip, M. Chung, J. Kulig, R. O'Brien, R. Sege, S. Glicken, M. J. Maisels, J. Lau, and Subcommittee on Hyperbilirubinemia
An Evidence-Based Review of Important Issues Concerning Neonatal Hyperbilirubinemia
Pediatrics, July 1, 2004; 114(1): e130 - e153.
[Abstract] [Full Text] [PDF]