The effect of head covering in prevention of phototherapy‑induced hypocalcemia in icterus newborns with gestational age less than 35 weeks

Hypocalcemia is one of the complications of phototherapy resulted from influence of phototherapy in melatonin secretion reducing corticosterone and ultimately increasing bone uptake. In this study, effect of head covering in prevention of this common and serious complication is studied.

This prospective, randomized clinical trial study conducted on premature infants with gestational age <35 weeks with jaundice. Infants were divided into two groups (n = 43). The first group (intervention group) and the second group (control group) while on the cut, underwent phototherapy using four blue fluorescent lamps in distance of 35 cm. Eyes and genitalia were protected using appropriate clothing. In the first group, head was covered using cloth helmet with a suitable size. For both groups, serum calcium was measured before and 36 h after starting phototherapy.

Mean serum calcium before phototherapy in both intervention and control groups was 8.72 ± 1.12 and 8.79 ± 0.87 mg/dL, respectively, and the difference between groups was not significant (P = 0.76). After treatment, calcium level in both intervention and control groups was 8.9 ± 0.82 and 8.43 ± 0.91, respectively, and the difference between the two groups was significant (P = 0.015). Mean serum calcium levels after phototherapy in the intervention group was −0.17 ± 1.46 (increase) and it was 0.35 ± 0.71 (decrease) in the control group. According to t‑test, the difference between the two groups was significant (P = 0.036).

Head covering during phototherapy probably prevents from hypocalcemia.