Background: Red blood cell breakdown creates bilirubin. Red cell breakdown creates unconjugated (indirect) bilirubin, which circulates mostly bound to albumin although some is free and hence able to enter the brain. Unconjugated bilirubin is metabolized by the liver to conjugated bilirubin then excreted in stool. Since the 1960s, phototherapy has treated neonatal hyperbilirubinemia. The treatment has improved as the light sources and strategy for using these have been optimized. Phototherapy replaces exchange transfusions due to its efficacy and safety. Phototherapy changes native, non-polar, and neurotoxic Z,Z-bilirubin to more polar isomers called photo bilirubins, which consist of Z,E- and E,Z-bilirubin and E,Z- and E,E-lumirubin. Hemoglobin and bilirubin compete for light absorption.
Aim of the study: This study aimed to assess the influence of hemoglobin level on the efficacy of phototherapy for treating neonatal jaundice in neonates.
Subject and Methods: This is a prospective observational study carried out on 100 neonates with pathological indirect hyperbilirubinemia. This study had been done at AL-Hussein University Hospital, in the period from February 2022 to October 2022.
Results: Our study results showed that hematocrit levels ranged from 25 to 68 with mean ± SD = 44.14 ± 7.55. Hemoglobin levels ranged from11.5 to 20.5 with mean value of 14.12 ± 1.04 gm/dl. There was a statically significant negative correlation according to Pearson's correlation coefficients (r) between total serum bilirubin concentration change after 24 h of phototherapy and hemoglobin levels.
Conclusion: We concluded that hemoglobin had a significant effect on the efficacy of phototherapy: the higher the hemoglobin concentration, the smaller the decrease in TSB. This knowledge is important for clinicians who treat hyperbilirubinemic infants with phototherapy.