{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:47:17Z","timestamp":1788850037824,"version":"build-2803163510"},"reference-count":66,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,1,9]],"date-time":"2013-01-09T00:00:00Z","timestamp":1357689600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evid.\u2010Based Child Health"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinaemia and jaundice that can lead to bilirubin encephalopathy. Phototherapy is the most common treatment for neonatal hyperbilirubinaemia and could be most effective in preventing the sequelae of hyperbilirubinaemia if initiated prophylactically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the efficacy and safety of prophylactic phototherapy for preterm (&lt; 37 weeks gestational age) or low birth weight infants (birth weight &lt; 2500 g).<\/jats:p><\/jats:sec><jats:sec><jats:title>Search methods<\/jats:title><jats:p>We searched the Cochrane Central Register of Controlled Trials (CENTRAL, T<jats:italic>he Cochrane Library<\/jats:italic>, Issue 3) on 31 March 2011,\u00a0MEDLINE (1950 to 31 March 2011), EMBASE (1980 to 31 March 2011) and CINAHL (1982 to 31 March 2011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Randomised controlled trials or quasi\u2010randomised controlled studies\u00a0evaluating the effects of prophylactic phototherapy for preterm or low birth weight infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two authors independently obtained data from published articles. We performed fixed\u2010effect meta\u2010analysis for the outcomes: rate of exchange transfusion, cerebral palsy or other neurodevelopmental impairment, peak serum bilirubin level and all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Nine studies of 3449 participants were included. The rate of exchange transfusion was reduced in one study with liberal transfusion criteria (risk ratio (RR) 0.20; 95% confidence interval (CI) 0.13 to 0.31) but not in the other two more recent studies with stringent criteria (typical RR 0.66; 95% CI 0.19 to 2.28). There was no statistically significant difference in the rate of cerebral palsy (typical RR 0.96; 95% CI 0.50 to 1.85; two studies, 756 participants). However, one large study that reported on neurodevelopmental impairment (a composite outcome including cerebral palsy) found a slightly lower rate of neurodevelopmental impairment with prophylactic phototherapy (RR 0.85; 95% CI 0.74 to 0.99; 1804 participants). The prophylactic phototherapy group had lower peak bilirubin levels (mean difference (MD) \u20102.73; 95% CI \u20102.89 to \u20102.57; six studies, 2319 participants) and had fewer neonates with peak unconjugated serum bilirubin levels &gt; 10 mg\/dl (typical RR 0.27; 95% CI 0.22 to 0.33; three studies, 1090 participants) or peak unconjugated serum bilirubin levels &gt; 15 mg\/dl (typical RR 0.13; 95% CI 0.07 to 0.23; four studies, 1116 participants). There was no statistically significant difference in the rate of all\u2010cause mortality between the two groups (typical RR 1.08; 95% CI 0.93 to 1.26; four studies, 3044 participants).<\/jats:p><\/jats:sec><jats:sec><jats:title>Authors' conclusions<\/jats:title><jats:p>Prophylactic phototherapy helps to maintain a lower serum bilirubin concentration and may have an effect on the rate of exchange transfusion and the risk of neurodevelopmental impairment. However, further well\u2010designed studies are needed to determine the efficacy and safety of prophylactic phototherapy on long\u2010term outcomes including neurodevelopmental outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p><jats:bold>Prophylactic phototherapy for preventing jaundice in preterm very low birth weight infants<\/jats:bold><\/jats:p><jats:p>Preterm (&lt; 37 weeks gestational age) or low birth weight (LBW; birth weight &lt; 2500 g) infants have a greater risk of developing jaundice compared to term or normal birth weight infant. This can be concerning because jaundice (caused by high levels of serum unconjugated bilirubin) could lead to permanent brain damage and\/or death.<\/jats:p><jats:p>In this review we evaluated the efficacy and safety of prophylactic phototherapy in preventing jaundice in preterm or LBW infants. A total of nine clinical trials representing 3449 infants were included. The findings suggest that phototherapy initiated soon after birth (within 36 hours) for preterm or low birth weight infants may prevent the serum bilirubin from reaching a level that would require exchange transfusion and may reduce the risk of impairment of brain and central nervous system development. However, further well\u2010designed studies are needed to evaluate the effects of prophylactic phototherapy on brain and central nervous system development and other long\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ebch.1898","type":"journal-article","created":{"date-parts":[[2013,1,9]],"date-time":"2013-01-09T19:26:00Z","timestamp":1357759560000},"page":"204-249","source":"Crossref","is-referenced-by-count":15,"title":["Cochrane Review: Prophylactic phototherapy for preventing jaundice in preterm or low birth weight infants"],"prefix":"10.1002","volume":"8","author":[{"given":"Charles I","family":"Okwundu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy AN","family":"Okoromah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakeshkumar S","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,9]]},"reference":[{"key":"e_1_2_16_2_1","unstructured":"References to studies included in this review"},{"key":"e_1_2_16_3_1","unstructured":"Brown 1985 {published data only}"},{"key":"e_1_2_16_4_1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1542\/peds.75.2.393","article-title":"Efficacy of phototherapy in prevention and management of neonatal hyperbilirubinemia","volume":"75","author":"Brown AK","year":"1985","journal-title":"Pediatrics"},{"key":"e_1_2_16_5_1","first-page":"417","article-title":"Morbidity and mortality associated with exchange transfusion","volume":"75","author":"Keenan WJ","year":"1885","journal-title":"Pediatrics"},{"key":"e_1_2_16_6_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1542\/peds.75.2.422","article-title":"Neonatal and infant mortality in relation to phototherapy","volume":"75","author":"Lipsitz PJ","year":"1985","journal-title":"Pediatrics"},{"issue":"4","key":"e_1_2_16_7_1","first-page":"445","article-title":"Phototherapy for neonatal hyperbilirubinemia: six\u2010year follow\u2010up of the National Institute of Child Health and Human Development clinical trial","volume":"85","author":"Scheidt PC","year":"1990","journal-title":"Pediatrics"},{"key":"e_1_2_16_8_1","first-page":"427","article-title":"Metabolic aspects of phototherapy","volume":"75","author":"Wu YK","year":"1985","journal-title":"Pediatrics"},{"key":"e_1_2_16_9_1","unstructured":"Curtis 1985 {published data only}"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80632-6"},{"key":"e_1_2_16_11_1","unstructured":"Giunta 1969 {published data only}"},{"key":"e_1_2_16_12_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1542\/peds.44.2.162","article-title":"Effect of environmental illumination in prevention of hyperbilirubinemia of prematurity","volume":"44","author":"Giunta F","year":"1969","journal-title":"Pediatrics"},{"key":"e_1_2_16_13_1","unstructured":"Hodgman 1970 {published data only}"},{"issue":"6","key":"e_1_2_16_14_1","first-page":"473","article-title":"Phototherapy and hyperbilirubinemia of the premature","volume":"119","author":"Hodgman JE","year":"1970","journal-title":"American Journal of Diseases of Children"},{"key":"e_1_2_16_15_1","unstructured":"Jangaard 2007 {published data only}"},{"issue":"10","key":"e_1_2_16_16_1","first-page":"853","article-title":"A randomized trial of aggressive versus conservative phototherapy for hyperbilirubinemia in infants weighing less than 1500g: short\u2010 and long\u2010term outcomes","volume":"12","author":"Jangaard KA","year":"2007","journal-title":"Paediatrics and Child Health"},{"key":"e_1_2_16_17_1","unstructured":"Leite 2004 {published data only}"},{"issue":"4","key":"e_1_2_16_18_1","doi-asserted-by":"crossref","first-page":"285","DOI":"10.2223\/1201","article-title":"Evaluation of two guidelines for the management of hyperbilirubinemia in newborn babies weighing less than 2,000 g","volume":"80","author":"Leite MGC","year":"2004","journal-title":"Jornal de Pediatria"},{"key":"e_1_2_16_19_1","unstructured":"Lucey 1968 {published data only}"},{"key":"e_1_2_16_20_1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1542\/peds.41.6.1047","article-title":"Prevention of hyperbilirubinemia of prematurity by phototherapy","volume":"41","author":"Lucey J","year":"1968","journal-title":"Pediatrics"},{"key":"e_1_2_16_21_1","unstructured":"Morris 2008 {published data only}"},{"key":"e_1_2_16_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803024"},{"key":"e_1_2_16_23_1","unstructured":"Tripathi 2006 {published data only}"},{"key":"e_1_2_16_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5359.27224"},{"key":"e_1_2_16_25_1","unstructured":"References to studies excluded from this review"},{"key":"e_1_2_16_26_1","unstructured":"Elliot 1974 {published data only}"},{"key":"e_1_2_16_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.49.1.60"},{"key":"e_1_2_16_28_1","unstructured":"Romagnoli 1996 {published data only}"},{"issue":"8","key":"e_1_2_16_29_1","first-page":"208","article-title":"Early or late phototherapy in the treatment of extremely preterm infants","volume":"16","author":"Romagnoli C","year":"1996","journal-title":"Pediatria Oggi Medica e Chirurgica"},{"key":"e_1_2_16_30_1","unstructured":"Sanches 2004 {published data only}"},{"key":"e_1_2_16_31_1","unstructured":"SanchesFBS AlmeidaFB DraqueCM SanudoA PeresCA KopelmanBI. Prophylactic versus therapeutic phototherapy in very low birthweight infants. Pediatric Research.2004. [CENTRAL: CN\u201000614394]"},{"key":"e_1_2_16_32_1","unstructured":"Yaseen 2005 {published data only}"},{"key":"e_1_2_16_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211356"},{"key":"e_1_2_16_34_1","unstructured":"Additional references"},{"key":"e_1_2_16_35_1","unstructured":"Almeida 2004"},{"key":"e_1_2_16_36_1","doi-asserted-by":"publisher","DOI":"10.2223\/JPED.1197"},{"key":"e_1_2_16_37_1","unstructured":"Bratlid 2001"},{"key":"e_1_2_16_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7210656"},{"key":"e_1_2_16_39_1","unstructured":"Bryla 1985"},{"issue":"2","key":"e_1_2_16_40_1","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1542\/peds.75.2.387","article-title":"Development, design and sample composition","volume":"75","author":"Bryla DA","year":"1985","journal-title":"Pediatrics"},{"key":"e_1_2_16_41_1","doi-asserted-by":"crossref","unstructured":"Gale 2001","DOI":"10.1353\/urb.2001.0007"},{"key":"e_1_2_16_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200487"},{"key":"e_1_2_16_43_1","unstructured":"Hansen 1996"},{"key":"e_1_2_16_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992289603500604"},{"key":"e_1_2_16_45_1","unstructured":"Hansen 2005"},{"issue":"5","key":"e_1_2_16_46_1","first-page":"594","article-title":"Treatment of neonatal jaundice","volume":"125","author":"Hansen TW","year":"2005","journal-title":"Tidsskr Nor Laegeforen"},{"key":"e_1_2_16_47_1","unstructured":"Hegyi 1994"},{"issue":"4","key":"e_1_2_16_48_1","first-page":"296","article-title":"The protective role of bilirubin in oxygen radical disease of the preterm infant","volume":"14","author":"Hegyi T","year":"1994","journal-title":"Journal of Perinatology"},{"key":"e_1_2_16_49_1","unstructured":"Higgins 2003"},{"issue":"7414","key":"e_1_2_16_50_1","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta\u2010analyses","volume":"362","author":"Higgins JP","year":"2003","journal-title":"BMJ"},{"key":"e_1_2_16_51_1","doi-asserted-by":"crossref","unstructured":"Higgins 2008","DOI":"10.12968\/indn.2008.29.2.75609"},{"key":"e_1_2_16_52_1","doi-asserted-by":"crossref","DOI":"10.1002\/9780470712184","volume-title":"Cochrane Handbook for Systematic Reviews of interventions Version 5.0.0. [updated February 2008]","author":"Higgins JPT","year":"2008"},{"key":"e_1_2_16_53_1","unstructured":"Kumar 1999"},{"issue":"7","key":"e_1_2_16_54_1","first-page":"679","article-title":"Neonatal jaundice. An update for family physicians","volume":"28","author":"Kumar RK","year":"1999","journal-title":"Australian Family Physician"},{"key":"e_1_2_16_55_1","unstructured":"Maisels 1998"},{"key":"e_1_2_16_56_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199804001-01085"},{"key":"e_1_2_16_57_1","unstructured":"McDonagh 1990"},{"key":"e_1_2_16_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0095-5108(18)30572-4"},{"key":"e_1_2_16_59_1","unstructured":"Papile 1978"},{"key":"e_1_2_16_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_16_61_1","unstructured":"RevMan 2008"},{"key":"e_1_2_16_62_1","unstructured":"The Nordic Cochrane Centre The Cochrane Collaboration. Review Manager (RevMan). 5.0. Copenhagen: The Nordic Cochrane Centre The Cochrane Collaboration 2008."},{"key":"e_1_2_16_63_1","unstructured":"Rubaltelli 1983"},{"key":"e_1_2_16_64_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198305000-00004"},{"key":"e_1_2_16_65_1","unstructured":"Turkel 1980"},{"issue":"4","key":"e_1_2_16_66_1","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1542\/peds.66.4.502","article-title":"Lack of identifiable risk factors for kernicterus","volume":"66","author":"Turkel SB","year":"1980","journal-title":"Pediatrics"},{"key":"e_1_2_16_67_1","unstructured":"*Indicates the major publication for the study"}],"container-title":["Evidence-Based Child Health: A Cochrane Review Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Febch.1898","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ebch.1898","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,4]],"date-time":"2024-05-04T14:16:01Z","timestamp":1714832161000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ebch.1898"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":66,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1002\/ebch.1898"],"URL":"https:\/\/doi.org\/10.1002\/ebch.1898","archive":["Portico"],"relation":{},"ISSN":["1557-6272","1557-6272"],"issn-type":[{"value":"1557-6272","type":"print"},{"value":"1557-6272","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}