Komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah di RSUD Wangaya Kota Denpasar
Authors: Ancelia Limantara  , Wayan Bikin Suryawan  , Anak Agung Made Sucipta  , Han's Christian  
Published: November 2023

Background: A bilirubin level in the blood higher than normal is called hyperbilirubinemia. Hyperbilirubinemia's prevalence is 60% in term newborns and 80% in preterm newborns. Low birth weight is a risk factor for hyperbilirubinemia. Phototherapy for low birth weight with hyperbilirubinemia is given for a longer time and has a higher rebound effect. This study aims to compare phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth weight.
Methods: Analytical study using medical records at Wangaya Hospital during January 2020-January 2022. Inclusion criteria include hyperbilirubinemia required phototherapy, bilirubin level before and after phototherapy checked, and single light phototherapy. Exclusion criteria include conjugated hyperbilirubinemia, exchange transfusion, sepsis, severe congenital malformation, patients in NICU and incomplete medical record.
Results: From 99 study subjects, 19% had low birth weight, and 81% had normal birth weight. The mean bilirubin serum before phototherapy was 15.52mg/dL for LBW and 15.27mg/dL for NBW. The mean bilirubin serum after phototherapy was 5.77mg/dL for LBW and 7.46mg/dL for NBW. The mean bilirubin difference was 9.75mg/dL for LBW and 7.81mg/dL for NBW. The mean phototherapy duration was 52 hours for LBW and 47.6 hours for NBW. Decreasing rate of bilirubin was 0.19mg/dL/hour for LBW and 0.18mg/dL/hour for NBW. Independent t-test showed a p-value of 0.571, meaning no significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth.
Conclusion: No significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between NBW and LBW. But, phototherapy in LBW was started earlier, required more time and has a lower bilirubin level target than NBW.

Latar Belakang: Bilirubin darah melebihi normal disebut hiperbilirubinemia. Prevalensi hiperbilirubinemia berkisar antara 60% pada bayi cukup bulan dan 80% pada bayi prematur. Bayi berat lahir rendah merupakan risiko hiperbilirubinemia. Fototerapi bayi berat lahir rendah diberikan lebih lama daripada bayi berat lahir normal dan memiliki efek rebound lebih tinggi. Tujuan penelitian adalah mengetahui komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.
Metode: Penelitian analitik menggunakan rekam medis di RSUD Wangaya Kota Denpasar periode Januari 2020-Januari 2022. Kriteria inklusi pada penelitian ini adalah pasien hyperbilirubinemia yang memerlukan fototerapi, kadar bilirubin sebelum dan sesudah fototerapi, dan fototerapi single-light. Kriteria eksklusi meliputi hiperbilirubinemia terkonjugasi, transfusi tukar, sepsis, kelainan kongenital berat, pasien perawatan di NICU, serta rekam medis tidak lengkap.
Hasil: Dari 99 subyek penelitian, 19% BBLR dan 81% BBLN. Rerata bilirubin pre-fototerapi 15,52 mg/dL pada BBLR dan 15,27 mg/dL pada BBLN. Rerata bilirubin post fototerapi 5,77mg/dL pada BBLR dan 7.46 mg/dL pada BBLN. Rerata selisih bilirubin fototerapi 9,75 mg/dL pada BBLR dan 7,81 mg/dL pada BBLN. Rerata waktu fototerapi 52 jam pada BBLR dan 47,6 jam pada BBLN. Laju turun bilirubin 0,19 mg/dL/jam pada BBLR dan 0,18 mg/dL/jam pada BBLN. Uji t-test tidak berpasangan menunjukkan p-value > 0,05 yaitu 0,571 menandakan tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.
Kesimpulan: Tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah. Namun, didapatkan bahwa fototerapi dimulai pada usia yang lebih awal, dengan waktu fototerapi yang lebih lama dan target bilirubin pasca fototerapi yang lebih rendah pada kelompok BBLR dibandingkan BBLN.