POSITION AND PROTECTION IN NEONATAL PHOTOTHERAPY: A RANDOMIZED CONTROLLED TRIAL EVALUATING HYPOCALCEMIA RISK

Authors

  • DR. VELISETTY VENKATA NARASIMHA KARTHIK DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.
  • DR. VARUN MUDDASANI DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.
  • DR. ELILARASI S DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES
  • DR. VIDHYASAGAR K DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.
  • DR. SHAPNA LAKSHMI THIRUMURUGESAN DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.
  • DR. DHANASANGARI MANIVANNAN DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.
  • DR. LAVANYA PANCHATCHARAM DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.
  • DR. VANKANA KANCHAN REDDY DEPARTMENT OF PAEDIATRICS, SAVEETHA INSTITUTE OF MEDICAL SCIENCES.

Keywords:

Phototherapy, Hypocalcemia, Neonate, Head covering, Prone position, Randomized controlled trial, Hyperbilirubinemia, Neonatal care, Serum calcium.

Abstract

Background

Phototherapy-induced hypocalcemia is a well-recognized yet often under-monitored complication in neonates undergoing treatment for hyperbilirubinemia. This study assessed the role of head covering and body positioning in minimizing this risk while maintaining phototherapy efficacy.

Objectives

To evaluate the effect of head covering and prone positioning on the incidence of hypocalcemia in term neonates receiving phototherapy.

Trial Design

Prospective, parallel-group, randomized controlled trial with a 1:1:1:1 allocation ratio.

Methods

A total of 180 term neonates with non-hemolytic hyperbilirubinemia were randomized into four groups: Supine without head covering, Supine with head covering, Prone without head covering, and Prone with head covering. All neonates underwent standardized LED phototherapy for 24 hours. Pre- and post-therapy serum calcium and bilirubin levels were measured, and clinical signs of hypocalcemia were monitored. The primary outcome was the incidence of hypocalcemia (serum calcium <8.0 mg/dL); secondary outcomes included change in serum calcium and bilirubin levels.

Results

Baseline characteristics were comparable across all groups. The incidence of hypocalcemia differed significantly (p = 0.001), with the lowest observed in the Prone + Head Covered group (13.3%) and the highest in the Supine + No Head Covering group (53.3%). Post-therapy serum calcium was highest in the Protected Prone group (8.5 mg/dL) and lowest in the Standard Supine group (8.0 mg/dL; p < 0.001). Bilirubin reduction was greatest in the Standard Prone group (6.5 mg/dL), with significant differences between groups (p = 0.023), but without compromising safety when head covering was used.

 

Conclusions

Head covering during phototherapy significantly reduces the risk of hypocalcemia in term neonates. When combined with prone positioning, the protective effect is enhanced while preserving phototherapy efficacy. This intervention is simple, cost-effective, and especially beneficial in resource-limited settings.

 

 

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How to Cite

KARTHIK, D. V. V. N., MUDDASANI, D. V., S, D. E., K, D. V., THIRUMURUGESAN, D. S. L., MANIVANNAN, D. D., … REDDY, D. V. K. (2025). POSITION AND PROTECTION IN NEONATAL PHOTOTHERAPY: A RANDOMIZED CONTROLLED TRIAL EVALUATING HYPOCALCEMIA RISK. TPM – Testing, Psychometrics, Methodology in Applied Psychology, 32(S3(2025) : Posted 07 July), 1631–1642. Retrieved from https://tpmap.org/submission/index.php/tpm/article/view/917

Issue

Vol. 32 No. S3(2025) : Posted 07 July (2025)

Section

Articles

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This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.