Therapeutic equivalence of intermittent and continuous phototherapy for neonatal jaundice: a systematic review & meta-analysis with regression and trial sequential analysis

Warsame HA, Theuri C, Abdullahi NM, Ahmed Keynan AM, Ahmed MAM (2025) Prevalence and risk factors for neonatal jaundice: a multicentre analytical cross-sectional study at neonatal intensive care units, Mogadishu, Somalia. BMJ Open 15(3):e096692. https://doi.org/10.1136/bmjopen-2024-096692

Article  PubMed  PubMed Central  Google Scholar 

Kliegman RM, St Geme JW, Blum NJ (2023) Nelson textbook of pediatrics, 22nd ed. Elsevier

Google Scholar 

Le Pichon JB, Riordan SM, Watchko J, Shapiro SM (2017) The neurological sequelae of neonatal hyperbilirubinemia: definitions, diagnosis and treatment of the kernicterus spectrum disorders. Curr Pediatr Rev 13(3):199–209. https://doi.org/10.2174/1573396313666170815100214

Article  PubMed  CAS  Google Scholar 

Maisels MJ, McDonagh AF (2008) Phototherapy for neonatal jaundice. N Engl J Med 358:920–928. https://doi.org/10.1056/NEJMct0708376

Article  PubMed  CAS  Google Scholar 

Stokowski LA (2006) Fundamentals of phototherapy for neonatal jaundice. Adv Neonatal Care 6:303–312. https://doi.org/10.1016/j.adnc.2006.08.003

Article  PubMed  Google Scholar 

Lindqvist D, Hansson M, Thomas M et al (2025) Bilirubin photoisomers in neonatal jaundice. Int J Mol Sci 26(21):10791. https://doi.org/10.3390/ijms262110791

Article  PubMed  PubMed Central  CAS  Google Scholar 

Maurer HM, Shumway CN, Draper DA, Hossaini AA (1973) Controlled trial comparing agar, intermittent phototherapy, and continuous phototherapy for reducing neonatal hyperbilirubinemia. J Pediatr 82(1):73–76. https://doi.org/10.1016/s0022-3476(73)80014-9

Article  PubMed  CAS  Google Scholar 

Patel A, Vagha JD, Meshram RJ et al (2024) Illuminating progress: evolution of phototherapy for neonatal hyperbilirubinemia. Cureus 16(3):e55608. https://doi.org/10.7759/cureus.55608

Article  PubMed  PubMed Central  Google Scholar 

Mendelson S (2023) Neonatal phototherapy adverse effects: a scoping review. Med Res Arch 11(7.1). https://doi.org/10.18103/mra.v11i7.1.4099

Tan KL (2014) Postnatal management of neonatal jaundice. Acta Paediatr 103:e127–e132. https://doi.org/10.1111/apa.12490

Article  Google Scholar 

Zhou S, Wu X, Ma A, Zhang M, Liu Y (2019) Therapeutic effect of intermittent vs continuous phototherapy in neonatal hemolytic jaundice. Exp Ther Med. https://doi.org/10.3892/etm.2019.7432

Article  PubMed  PubMed Central  Google Scholar 

Chu L, Xue X, Qiao J (2021) Efficacy of intermittent phototherapy versus continuous phototherapy for treatment of neonatal hyperbilirubinaemia: a systematic review and meta-analysis. J Adv Nurs 77(1):12–22. https://doi.org/10.1111/jan.14535

Article  PubMed  Google Scholar 

Higgins JPT, Thomas J, Chandler J (2019) Cochrane handbook for systematic reviews of interventions, 2nd ed. Wiley. https://doi.org/10.1002/9781119536604

Book  Google Scholar 

Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71

Article  PubMed  PubMed Central  Google Scholar 

Wan X, Wang W, Liu J, Tong T (2014) Estimating mean and SD from median and range/IQR. BMC Med Res Methodol 14:135. https://doi.org/10.1186/1471-2288-14-135

Article  PubMed  PubMed Central  Google Scholar 

Sterne JAC, Savović J, Page MJ et al (2019) RoB 2: revised tool for risk of bias in randomized trials. BMJ 366:l4898. https://doi.org/10.1136/bmj.l4898

Article  PubMed  Google Scholar 

Thorlund K, Engstrøm J, Wetterslev J, Brok J, Imberger G, Gluud C (2011) User manual for trial sequential analysis (TSA). Copenhagen trial unit. Available at: www.ctu.dk/tsa

Wetterslev J, Thorlund K, Brok J, Gluud C (2008) Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. J Clin Epidemiol 61(1):64–75. https://doi.org/10.1016/j.jclinepi.2007.03.013

Article  PubMed  Google Scholar 

Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: rating quality of evidence and strength of recommendations. BMJ 336:924–926. https://doi.org/10.1136/bmj.39489.470347.AD

Article  PubMed  PubMed Central  Google Scholar 

Ahmad M, Anwar M, Hussain A, Javeed A (2023) Intermittent versus continuous phototherapy among term infants presenting with non-hemolytic moderate hyperbilirubinemia at a tertiary care hospital: a randomized controlled trial. Prof Med J 30(6):695–699. https://doi.org/10.29309/TPMJ/2023.30.06.7479

Article  Google Scholar 

Arnold C et al (2020) Intermittent phototherapy in extremely preterm infants: a randomized clinical trial. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2020.0559

Article  PubMed  PubMed Central  Google Scholar 

Asharab M et al (2025) Comparison of intermittent versus continuous phototherapy in neonatal hyperbilirubinemia. Int J Biol Res 3(4). https://doi.org/10.70749/ijbr.v3i4.2049

Demirel HN, SevukOzumut S, Ovalı HF (2024) Continuous versus intermittent phototherapy in treatment of neonatal jaundice: a randomized controlled trial. Eur J Pediatr 183(8):3389–3396. https://doi.org/10.1007/s00431-024-05610-7

Article  PubMed  CAS  Google Scholar 

Girija G, Reddy KR, Ravichander B (2021) The efficacy of intermittent versus continuous phototherapy in the duration of phototherapy required in the given bilirubin level. Int J Paediatr Geriatr 4(1):18–21. https://doi.org/10.33545/26643685.2021.v4.i1a.119

Article  Google Scholar 

Gottimukkala SB, Sethuraman G, Kitchanan S, Pathak S (2021) Comparison of efficacy, safety & satisfaction of intermittent versus continuous phototherapy in hyperbilirubinaemic newborns ≥35 week gestation: a randomized controlled trial. Indian J Med Res 153(4):446–452. https://doi.org/10.4103/IJMR.IJMR_2156_18

Article  PubMed  PubMed Central  CAS  Google Scholar 

Gowtami GS (2019) Continuous and intermittent phototherapy in the management of neonatal hyperbilirubinemia: a randomised intervention study. MD Dissertation. BLDE (Deemed to be University), Shri B. M. Patil Medical College, Hospital & Research Centre, Vijayapura, India

Hamidi M et al (2021) Intermittent versus continuous phototherapy in neonatal hyperbilirubinemia. J Chem Health Risks. https://doi.org/10.22034/jchr.2021.1910275.1188

Article  Google Scholar 

Kareem HM et al (2011) Comparison between continuous and intermittent phototherapy in the management of neonatal jaundice. Zanco J Med Sci 15(2):40–44

Article  Google Scholar 

Khalid MA, Bakhtawar A, Akbar N (2017) Comparison of continuous with intermittent phototherapy technique for the management of neonatal jaundice. Med Forum 28(9):71–74

Google Scholar 

Khaliq A (2016) Comparison of continuous with intermittent phototherapy in the treatment of neonatal jaundice. J Postgrad Med Inst 30(2):173–176

Google Scholar 

Khandwal O et al (2024) Comparison between the efficacy of continuous phototherapy and intermittent phototherapy in the treatment of neonatal jaundice. Perinatology 25(2):114–122

Google Scholar 

Lau SP, Fung KP (1984) Serum bilirubin kinetics in intermittent phototherapy of physiological jaundice. Arch Dis Child. https://doi.org/10.1136/adc.59.9.892

Article  PubMed  PubMed Central  Google Scholar 

Mari A et al (2021) Comparison of intermittent versus continuous phototherapy in neonatal hyperbilirubinemia. J Pharm Res Int 33(52A):26–31. https://doi.org/10.9734/JPRI/2021/v33i52A33554

Article  Google Scholar 

Niknafs P et al (2008) Intermittent versus continuous phototherapy in neonatal hyperbilirubinemia. Iran J Pediatr 18(3):251–256

Google Scholar 

Ong SH et al (2026) Continuous versus intermittent phototherapy in neonatal jaundice: a randomized controlled trial. Eur J Pediatr 185:67. https://doi.org/10.1007/s00431-025-06727-z

Article  PubMed  PubMed Central  Google Scholar 

Patil MM, Gowthami GS, Bijapure HR, Sajjan AK (2020) Continuous versus intermittent phototherapy in the management of non-hemolytic neonatal hyperbilirubinemia: a randomized non-inferiority study. J Nepal Paediatr Soc 40(3):185–189

Article  Google Scholar 

Sachdeva M, Murki S, Oleti TP, Kandraju H (2015) Intermittent versus continuous phototherapy in infants >34 weeks gestation: a randomized controlled trial. Eur J Pediatr 174:177–181. https://doi.org/10.1007/s00431-014-2373-8

Article  PubMed  CAS 

Comments (0)

No login
gif