title: Effect of position of infant during phototherapy in management of hyperbilirubinemia in late preterm and term neonates: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of supine position when compared with periodic change of position during phototherapy in late preterm and term neonates (35 to 42 weeks) with hyperbilirubinemia on the duration of phototherapy.
  
  
  METHODS
  We randomly allocated enrolled neonates with hyperbilirubinemia to either no change in position (supine group (SG); n=54) or two-hourly change of position from supine to prone and vice versa (turning group (TG); n=46). All the infants received single surface phototherapy by two dedicated compact fluorescent light units. Total serum bilirubin (TSB) was measured at the start of phototherapy and then every 12 ± 2 h until the end of phototherapy. Phototherapy was stopped when two values were below the cut-off for age and gestational age as per the American Academy of Pediatrics Subcommittee on Hyperbilirubinemia guidelines nomogram for the management of hyperbilirubinemia in infants >35 weeks of gestation. The primary outcome was duration of phototherapy and secondary outcome was rate of fall of bilirubin within the first 24 ± 2 h after the initiation of phototherapy.
  
  
  RESULTS
  Baseline characteristics including birth weight (g, 2752 ± 478 vs 2748 ± 416 P=0.96), gestation (week, 37.1 ± 1.2 vs 37.4 ± 1.3, P=0.26) were similar in the two groups. There was no difference in the duration of phototherapy between the SG (mean ± s.d., hour, 25.5 ± 8) and TG (mean ± s.d., hour, 24.8 ± 5), mean difference (95% confidence interval), hour, 0.7 (-2.03, 3.44, P=0.6). Rate of fall of bilirubin was also similar in both supine and turning groups with mean difference of -0.020 (95% confidence interval: -0.061, 0.021, P=0.34).
  
  
  CONCLUSIONS
  Nursing babies in supine position when compared with periodic position change during phototherapy does not decrease the duration of phototherapy.
authors.affiliation: Departments of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.identifier: 0000000165203819
authors.initials: S
authors.lastname: Bhethanabhotla
authors.forename: A
authors.initials: A
authors.lastname: Thukral
authors.forename: M J
authors.initials: MJ
authors.lastname: Sankar
authors.forename: R
authors.initials: R
authors.lastname: Agarwal
authors.forename: V K
authors.initials: VK
authors.lastname: Paul
authors.forename: A K
authors.initials: AK
authors.lastname: Deorari
mesh_terms: D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy; D008297:Male; D010789:Phototherapy / Q000379:methods*; D016684:Prone Position; D016683:Supine Position; D047929:Term Birth