Phototherapy modifies hematologic markers without inducing inflammation in neonates: a retrospective observational study
European Journal of Pediatrics, cilt.184, sa.7, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 184 Sayı: 7
- Basım Tarihi: 2025
- Doi Numarası: 10.1007/s00431-025-06240-3
- Dergi Adı: European Journal of Pediatrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE
- Anahtar Kelimeler: Phototherapy, Oxidative stress, Neonatal hyperbilirubinemia, Hematologic markers, Preterm infants
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Phototherapy is the standard treatment for neonatal hyperbilirubinemia. However, its impact on hematologic indices related to oxidative stress and systemic inflammation, particularly in preterm infants, remains insufficiently understood. In this retrospective observational study, 96 neonates who received phototherapy were evaluated. Hematologic ratios including red cell distribution width to platelet count (RDW/PLT), RDW to lymphocyte count (RDW/LF), and platelet distribution width to plateletcrit (PDW/PCT) were analyzed. Systemic inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SI), systemic immune inflammation index (SIRI), and pan-inflammatory value (PIV) were also compared before and after treatment using Wilcoxon signed-rank tests. Phototherapy was associated with an increase in RDW/PLT from a median of 0.11 to 0.14 (p = 0.0007, 95% CI 0.02 to 0.05) and in RDW/LF from 2.98 to 3.62 (p = 0.0005, 95% CI 0.50 to 0.80), as well as a decrease in PDW/PCT from 42.1 to 36.4 (p = 0.0001, 95% CI − 8.0 to − 4.5). No significant changes were observed in systemic inflammatory markers (p greater than 0.05 for all). Conclusion: Phototherapy induces localized hematologic changes that may reflect oxidative activity, without provoking systemic inflammation. RDW/PLT and RDW/LF may serve as accessible indicators of oxidative response. These findings support the hematologic safety of phototherapy in term and near-term neonates, while further research is needed in extremely preterm infants due to their increased susceptibility. (Table presented.)