USE OF CLOFIBRATE UNCONJUGATED HYPERBILIRUBINEMIA IN NEONATES
Abstract
INTRODUCTION: Hyperbilirubinaemia is a common problem in the neonatal period, occurring in around 60% of newborns. The treatment for for severe jaundice is exchange transfusion and phototherapy, but the need for exchange transfusion has markedly decreased because of the availability of effective phototherapy, and however a small proportion of infants with severe hyperbilirubinemia need exchange transfusion, which leads to increased risk of infections and death. Clofibrate increases the activity of extrahepatic lipoprotein lipase thereby increasing lipoprotein triglyceride lipolysis. This is accompanied by a slight increase in secretion of lipids into the bile and ultimately the intestine.
MATERIAL AND METHODS: This was a randomised control trial performed on 64 neonates admitted in the hospital during study period. Term neonate in which gestational age between 38-41 weeks, Weight ranging between 2500-4000 grams, age of the neonate between 2-7 days, Serum total bilirubin level between 17-26 mg/dl with priority of unconjugated bilirubin was included in the study. Case group were treated by clofibrate and phototherapy, while control group treated only with intense phototherapy. Clofibrate was administered as a single dose of 100 mg/kg. Phototherapy was discontinued when serum bilirubin level is lower than 10mg/dl. RESULTS: In case group (clofibrate and intense phototherapy) there were 16 (50%) male and 16(50%) female while in control group there were 18 (56.3%) male and 14 (43.8%) female. No statistically significant difference was observed between the cases and control group in terms of mean age, weight, total serum bilirubin and serum conjugated bilirubin. At 48 hours Serum bilirubin levels in case group was 7.65±0.74 while in control group was 11.47±1.10. There was a significant reduction in the serum bilirubin levels in the case group at 48 hours.
CONCLUSION: Administration of clofibrate before starting phototherapy was seen to be effective in reducing neonatal jaundice in term individuals.
