Faculty, Staff and Student Publications
Publication Date
10-30-2008
Journal
The New England Journal of Medicine
Abstract
BACKGROUND: It is unclear whether aggressive phototherapy to prevent neurotoxic effects of bilirubin benefits or harms infants with extremely low birth weight (1000 g or less).
METHODS: We randomly assigned 1974 infants with extremely low birth weight at 12 to 36 hours of age to undergo either aggressive or conservative phototherapy. The primary outcome was a composite of death or neurodevelopmental impairment determined for 91% of the infants by investigators who were unaware of the treatment assignments.
RESULTS: Aggressive phototherapy, as compared with conservative phototherapy, significantly reduced the mean peak serum bilirubin level (7.0 vs. 9.8 mg per deciliter [120 vs. 168 micromol per liter], P
CONCLUSIONS: Aggressive phototherapy did not significantly reduce the rate of death or neurodevelopmental impairment. The rate of neurodevelopmental impairment alone was significantly reduced with aggressive phototherapy. This reduction may be offset by an increase in mortality among infants weighing 501 to 750 g at birth. (ClinicalTrials.gov number, NCT00114543.)
Keywords
Bayes Theorem, Bilirubin, Birth Weight, Developmental Disabilities, Female, Humans, Hyperbilirubinemia, Neonatal, Infant Mortality, Infant, Extremely Low Birth Weight, Infant, Newborn, Male, Phototherapy, Treatment Outcome
DOI
10.1056/NEJMoa0803024
PMID
18971491
PMCID
PMC2821221
PubMedCentral® Posted Date
February 2010
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Included in
Internal Medicine Commons, Maternal and Child Health Commons, Maternal, Child Health and Neonatal Nursing Commons