Abstract
Background: Hyperbilirubinemia is one of the most frequently occurring problems in the neonatal period, and phototherapy has remained the primary treatment of choice. Fluid supplementation has been proposed to reduce serum bilirubin levels. Purpose: To assess the risks and benefits of fluid supplementation compared with standard fluid management in preterm infants with unconjugated hyperbilirubinemia under conventional phototherapy. Methods: A retrospective cohort study of preterm infants (gestational ages >= 28 to <= 32 weeks) admitted to the neonatal intensive care unit at the Maternity and Children Hospital in Jeddah, Saudi Arabia, from January 1, 2017, to December 31, 2017, and required the initiation of phototherapy in the first week of life. Results: One hundred and fifteen infants were included; 51 received fluid supplementation, and 64 received standard fluid management. There were no significant differences in demographic characteristics between groups. The infants who received fluid supplementation had a significantly larger decline in the total serum bilirubin level per day and a shorter phototherapy duration (P < .01). There were no significant differences in weight (P = .14), or sodium (P = .79) change per day or the need for exchange transfusion between groups. The prematurity-related inhospital morbidities were similar between groups. Implications for Practice and Research: Fluid supplementation in preterm infants receiving conventional phototherapy resulted in a faster decline in the bilirubin level and a shorter duration of phototherapy, without increasing prematurity-related morbidities. Future randomized controlled trials to assess the benefits and risks of fluid supplementation during conventional phototherapy in preterm infants are needed.