Intermittent Phototherapy Versus Continuous Phototherapy For Neonatal Hyperbilirubinaemia:a Systematic ReVIEW

Objective To eveluate the efficacy and safety of intermittent phototherapy and continuous phototherapy in treating neonatal hyperbilirubinemia.Methods The Cochrane Library, MEDLINE, VIP, and CNKI were searched. The quality of included studies was evaluated and meta-analysis was performed for the results of homogeneous studies.Results Sixteen studies involving1449participants related to hyperbilirubinemia were included. Meta-analysis based on different outcomes included studies showed that intermittent phototherapy group had a similar effect on reducing serum total bilirubin compared with continuous phototherapy group after treatment24hours [SMD0.45,95%CI (-0.67,1.56)],72hours [SMD0.51,95%CI (-0.02,1.03)], as well as effect on effective rate after48hours [RR1.00,95%CI (0.90,1.12)]. The serum total bilirubin in intermittent phototherapy group after treatment48hours were higher than that in continuous phototherapy group [SMD0.35,95%CI (0.02,0.69)], with statistical difference. However, intermittent phototherapy could reduced the risk of adverse reactions occurrence such as fever [OR0.22,95%CI (0.14,0.37)], diarrhea [OR0.25,95% CI (0.16,0.39)], rash [OR0.21,95%CI (0.12,0.36)] and hypocalcemia [OR0.23,95%CI (0.17,0.30)].Conclusions Intermittent phototherapy treatment of neonatal hyperbilirubinemia had the same effect compared with continuous phototherapy, but more secure. Due to high risk of selection bias and detection bias of included studies, the evidence is not strong enough. Our results suggest that further and larger-scale trials of the use of intermittent phototherapy and continuous phototherapy in the treatment of neonatal hyperbilirubinemia are needed.