COMPARISON OF EFFICACY OF PHOTOTHERAPY PLUS ALBUMIN VS PHOTOTHERAPY ALONE IN BABIES WITH NEONATAL JAUNDICE

Abstract

Background: Neonatal jaundice is one of the most common clinical conditions requiring medical attention during the neonatal period. Although phototherapy is the standard treatment for unconjugated hyperbilirubinemia, adjunctive therapies such as albumin infusion may enhance bilirubin reduction by increasing bilirubin-binding capacity and facilitating its clearance. Objective: To compare the efficacy of phototherapy plus albumin infusion versus phototherapy alone in neonates with neonatal jaundice. Methods: This randomized controlled trial was conducted in the Department of Pediatrics, Allied Hospital Faisalabad, from 12 February 2026 to 12 May 2026. A total of 620 neonates with neonatal jaundice requiring treatment were enrolled and randomly allocated into two equal groups. Group A (n=310) received standard phototherapy alone, whereas Group B (n=310) received phototherapy plus intravenous human albumin infusion at a dose of 1.5 g/kg during the first two hours of treatment. Serum total bilirubin levels were measured before treatment and after completion of therapy. Treatment efficacy was assessed based on a clinically significant reduction in serum bilirubin levels. Data were analyzed using SPSS version 25.0, and treatment efficacy was compared between groups using the Chi-square test. Results: Baseline demographic and clinical characteristics, including age, gender, weight, family history of jaundice, and pre-treatment serum bilirubin levels, were comparable between the two groups (p > 0.05). The mean post-treatment serum bilirubin level was significantly lower in the phototherapy-plus-albumin group than in the phototherapy-alone group (10.8 ± 1.7 vs. 14.3 ± 1.9 mg/dL; p < 0.001). The mean reduction in serum bilirubin was also significantly greater with combination therapy (7.9 ± 1.5 vs. 4.1 ± 1.3 mg/dL; p < 0.001). Treatment efficacy was significantly higher in Group B (44.5%, 138/310) than in Group A (21.6%, 67/310; χ² = 36.74, p < 0.001). Conclusion: Phototherapy combined with albumin infusion was significantly more effective than phototherapy alone in reducing serum bilirubin levels among neonates with jaundice. Albumin may provide additional bilirubin lowering benefit when used as an adjunct to phototherapy in appropriately selected neonates with significant hyperbilirubinemia. However, further studies evaluating unbound bilirubin, safety outcomes, and long-term neurological effects are warranted.