PHOTOTHERAPY FOR NEONATAL JAUNDICE IN INFANTS WITH CEPHALHEMATOMAS

The efficacy of phototherapy in a group of infants with nonhemolytic h yperbilirubinemia and no cephalhematomas was compared with a second gr oup of infants with large cephalhematomas (> 7 cm across), but:similar in all other aspects. The cephalhematoma group demonstrated significa ntly lower hemoglobin (Hb) and hematocrit (hct) values (P < .0001, P < .002 respectively) than the standard group, even after the latter gro up had been adjusted by stratification (P < .0001, P < .005) such that the starting bilirubin concentration, birth weight, and gestational a ge were highly comparable to the cephalhematoma group. The bilirubin c oncentrations of the cephalhematoma, original, and adjusted groups wer e 277.8 +/- 5.8 mu mol/L (16.24 +/- 0.03 mg/dL), [mean +/- semi], 265. 2 +/- 0.5 mu mol/L (15.50 +/- 0.03 mg/dL), and 275.2 +/- 0.9 mu mol/L (16.09 +/- 0.05 mg/dL), respectively. The postnatal age at the start o f phototherapy in the cephalhematoma group was comparable with that of the standard group before and after adjustment. Phototherapy was equa lly effective in the cephalhematoma and standard (original and adjuste d) groups of infants, in terms of duration, 24-hr decline, and overall decline/hr for the duration of exposure. The proportionate 24-hr decl ine was 24.02 +/- 1.90% vs 20.99 +/- 0.23% and 22.61 +/- 0.48% and ove rall decline/hr was 0.83 +/- 0.06% vs 0.74 +/- 0.01% and 0.78 +/- 0.01 %. We conclude that the sequestrated blood in the cephalhematomas did not significantly interfere with the efficacy of phototherapy.