Generic placeholder image

Current Pediatric Reviews

Editor-in-Chief

ISSN (Print): 1573-3963
ISSN (Online): 1875-6336

Clinical Trial

The Effect of Probiotics on Phototherapy for Bilirubin Reduction in Term Neonates: A Randomized Controlled Trial

Author(s): Fatemeh Eghbalian, Mohamad Kazem Sabzehei, Soroush Taheri Talesh, Roya Raeisi and Ensiyeh Jenabi*

Volume 21, Issue 1, 2025

Published on: 27 October, 2023

Page: [85 - 90] Pages: 6

DOI: 10.2174/0115733963257942231024100105

Price: $65

Open Access Journals Promotions 2
conference banner
Abstract

Background: This interventional study aimed to assess the impact of combining probiotics with phototherapy compared to using phototherapy alone on bilirubin reduction in term neonates hospitalized in neonatal wards in a pediatric hospital in western Iran.

Methods: This clinical trial study included 150 term neonates with a gestational age of 37 to 42 weeks, birth weight of more than 2500 g, and diagnosed with neonatal jaundice. Patients were equally assigned to two groups of phototherapy (wavelength 420-450 nm) with oral probiotics (PediLact drop, 10 drops daily) and phototherapy alone through a simple random sampling method. Serum bilirubin levels (SBL) at the time of intervention, and 24, 48, and 72 hours later, duration of phototherapy, duration of hospitalization, and the need for blood transfusion were compared in the two groups. We used t-test and repeated analysis of variance to compare continuous variables. SPSS24 software was used to analyze the data. The significance level was set as 0.05.

Results: There was no statistically significant difference found between the two groups regarding basic variables, gender, birth weight, gestational age, maternal age, and neonatal age at hospitalization time. On the first day of hospitalization, the mean serum bilirubin level (SBL) in the combinatory therapy group was 15.6 ± 1.7 mg/dl, while in the monotherapy group, it was 15.8 ± 1.6 mg/dl (p = 0.584). On the second day, the mean SBL in the combinatory therapy group was 11.2 ± 2.2, whereas in the monotherapy group, it was 12.4 ± 2.1. By the third day, these levels were 7.2 ± 0.9 and 7.8 ± 0.7, respectively, with a statistically significant difference between the two groups. Repeated analysis of variance testing confirmed a statistically significant decrease in serum bilirubin levels in both groups. The average length of hospital stay for the combinatory therapy group was 2.4 ± 0.5 days, compared to 2.8 ± 0.6 days in the phototherapy group (p = 0.001). In terms of phototherapy duration, the combinatory therapy group received treatment for 26.2 ± 9.9 hours, while the phototherapy group received it for 31.4 ± 10.3 hours (p = 0.001).

Conclusion: The findings of the present study indicate that incorporating oral probiotics into phototherapy for neonatal jaundice (icterus) treatment is associated with a reduction in phototherapy duration and hospital stay.

Keywords: Neonatal jaundice, phototherapy, probiotics, icterus, bilirubin excretion, mucous membranes.

Graphical Abstract
[1]
Wan A, Mat Daud S, Teh SH, Choo YM, Kutty FM. Management of neonatal jaundice in primary care. Malays Fam Physician 2016; 11(2-3): 16-9.
[PMID: 28461853]
[2]
Mitra S, Rennie J. Neonatal jaundice: Aetiology, diagnosis and treatment. Br J Hosp Med 2017; 78(12): 699-704.
[http://dx.doi.org/10.12968/hmed.2017.78.12.699] [PMID: 29240507]
[3]
Ambalavanan N, Carlo WA. Jaundice and Hyperbilirubinemia in the newborn. Philadelphia: Elsevier Saunders 2011.
[4]
Chee Y, Chung PH, Wong RM, Wong KK. Jaundice in infants and children: Causes, diagnosis, and management. Hong Kong Med J 2018; 24(3): 285-92.
[http://dx.doi.org/10.12809/hkmj187245]
[5]
Jirsa M, Sticová E. Neonatal hyperbilirubinemia and molecular mechanisms of jaundice. Vnitr Lek 2013; 59(7): 566-71.
[PMID: 23909260]
[6]
Ahmadipour S, Baharvand P, Rahmani P, Hasanvand A, Mohsenzadeh A. Effect of synbiotic on the treatment of jaundice in full term neonates: A randomized clinical trial. Pediatr Gastroenterol Hepatol Nutr 2019; 22(5): 453-9.
[http://dx.doi.org/10.5223/pghn.2019.22.5.453] [PMID: 31555570]
[7]
Dennery PA, Ed. Pharmacological interventions for the treatment of neonatal jaundice Seminars in neonatology. Elsevier 2002.
[8]
Eghbalian F, Jenabi E, Hatami E, Basiri B, Derakhshandeh K, Pezeshki N, et al. Clofibrate in the treatment of the non-hemolytic hyperbilirubinemia in preterm neonates in Western Iran. Iranian Journal of Neonatology 2021; 12(3)
[9]
Eghbalian F, Monsef F, Alam Ghomi N, Monsef A. Effect of low versus moderate dose of clofibrate on serum bilirubin in healthy term neonates with indirect hyperbilirubinemia. Iran J Med Sci 2013; 38(4): 349-50.
[PMID: 24293792]
[10]
Kumar P, Adhisivam B, Vishnu Bhat B. Clofibrate as an adjunct to phototherapy for unconjugated hyperbilirubinemia in term neonates. Indian J Pediatr 2017; 84(10): 763-7.
[http://dx.doi.org/10.1007/s12098-017-2360-y] [PMID: 28512725]
[11]
Kutz K, Kandler H, Gugler R, Fevery J. Effect of clofibrate on the metabolism of bilirubin, bromosulphophthalein and indocyanine green and on the biliary lipid composition in Gilbert’s syndrome. Clin Sci 1984; 66(4): 389-97.
[http://dx.doi.org/10.1042/cs0660389] [PMID: 6697662]
[12]
Husebye E, Hellström PM, Sundler F, Chen J, Midtvedt T. Influence of microbial species on small intestinal myoelectric activity and transit in germ-free rats. Am J Physiol Gastrointest Liver Physiol 2001; 280(3): G368-80.
[http://dx.doi.org/10.1152/ajpgi.2001.280.3.G368] [PMID: 11171619]
[13]
Ebbesen F, Hansen TWR, Maisels MJ. Update on phototherapy in jaundiced neonates. Curr Pediatr Rev 2017; 13(3): 176-80.
[PMID: 28721812]
[14]
Procianoy R, Silveira R, Faulhaber F. Side effects of phototherapy on neonates. Am J Perinatol 2019; 36(3): 252-7.
[http://dx.doi.org/10.1055/s-0038-1667379] [PMID: 30081405]
[15]
Eghbalian F, Pourhossein A, Zandevakili H. Effect of clofibrate in non-hemolytic indirect hyperbilirubinemia in full term neonates. Indian J Pediatr 2007; 74(11): 1003-6.
[http://dx.doi.org/10.1007/s12098-007-0184-x] [PMID: 18057680]
[16]
Armanian AM, Barekatain B, Hoseinzadeh M, Salehimehr N. Prebiotics for the management of hyperbilirubinemia in preterm neonates. J Matern Fetal Neonatal Med 2016; 29(18): 3009-13.
[http://dx.doi.org/10.3109/14767058.2015.1113520] [PMID: 26513278]
[17]
Armanian AM, Jahanfar S, Feizi A, Salehimehr N, Molaeinezhad M, Sadeghi E. Prebiotics for the prevention of hyperbilirubinaemia in neonates. Cochrane Database of Systematic Reviews 2019; 8
[http://dx.doi.org/10.1002/14651858.CD012731.pub2]
[18]
Demirel G, Celik IH, Erdeve O, Dilmen U. Impact of probiotics on the course of indirect hyperbilirubinemia and phototherapy duration in very low birth weight infants. J Matern Fetal Neonatal Med 2013; 26(2): 215-8.
[http://dx.doi.org/10.3109/14767058.2012.725115] [PMID: 22937831]
[19]
Yuan C, Chen J, Lu C. Efficacy of oral probiotics and its effect on immunity in treating hyperbilirubinemia of neonates. Jiangsu Medical Journal 2011; 2: 018.
[20]
Ling-ling W, Fen-lan B. A Clinical Observation on Effect of” Mamiai” on Lowering Breast Milk Jaundice by Quickly Constructing Intestinal Microflora. Clinical Journal of Medical Officer 2006; p. 4.
[21]
Torkaman M, Mottaghizadeh F, Khosravi MH, Najafian B, Amirsalari S, Afsharpaiman S. The effect of probiotics on reducing hospitalization duration in infants with hyperbilirubinemia. Iran J Pediatr 2017; 27(1)
[22]
Zahed Pasha Y, Ahmadpour-Kacho M, Ahmadi Jazi A, Gholinia H. Effect of probiotics on serum bilirubin level in term neonates with jaundice; A randomized clinical trial. Int J Pediatr 2017; 5(10): 5953-8.
[23]
Serce O, Gursoy T, Ovali F, Karatekin G. Effects of Saccharomyces boulardii on neonatal hyperbilirubinemia: A randomized controlled trial. Am J Perinatol 2015; 30(2): 137-42.
[PMID: 24915562]
[24]
Liu W, Liu H, Wang T, Tang X. Therapeutic effects of probiotics on neonatal jaundice. Pak J Med Sci 2015; 31(5): 1172-5.
[http://dx.doi.org/10.12669/pjms.315.7921] [PMID: 26649008]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy