Comparative Analysis of phototherapy protocols versus Standard Care in preterm birth complications

Mateo Rodriguez; L. Vargas; M. Ramirez

doi:10.5281/zenodo.22814765

Authors

Mateo Rodriguez Division of Neonatology, Amur Center for Pediatric Research Author https://orcid.org/4850-9668-3590-4240
L. Vargas Division of Neonatology, Amur Center for Pediatric Research Author https://orcid.org/1972-0291-0070-1252
M. Ramirez Department of Clinical Neonatology, Clyde Academy of Pediatric Research Author https://orcid.org/1496-3924-1039-7743

DOI:

https://doi.org/10.5281/zenodo.22814765

Keywords:

phototherapy, neonatal hyperbilirubinemia, preterm birth, kernicterus, extremely low birth weight

Abstract

Graphical abstract

Background: Unconjugated hyperbilirubinemia is nearly universal in preterm infants, and their more permeable blood-brain barrier makes even moderate bilirubin elevations a meaningful neurotoxic risk.

Objective: This review compares standard, gestational-age-threshold-guided phototherapy against more aggressive, high-intensity or double-surface protocols in preterm hyperbilirubinemia, and evaluates the contribution of device-level advances such as light-emitting diode phototherapy.

Methods: We synthesized randomized trials, cohort studies, systematic reviews, and guideline documents addressing phototherapy thresholds, treatment intensity, light-source technology, and safety outcomes in preterm infants.

Findings: Aggressive phototherapy reduced neurodevelopmental impairment among extremely low birth weight survivors above roughly 750 g but showed a nonsignificant mortality signal in the smallest infants; LED and double-surface devices achieved faster bilirubin decline with less thermal burden; and severe outcomes tracked more with delayed treatment escalation than with the threshold framework chosen.

Conclusions: Protocol selection should be individualized by birth weight and gestational age, with device-level improvements offering a low-risk route to better efficacy and prompt, reliable delivery mattering as much as the numeric threshold itself.

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