The Effect of Probiotics on Phototherapy for Bilirubin Reduction in Term Neonates: A Randomized Controlled Trial

Background: This interventional study aimed to assess the impact of combining probiotics with phototherapy compared to using phototherapy alone on bilirubin reduction in term neonates hospitalized in neonatal wards in a pediatric hospital in western Iran. Methods: This clinical trial study included 150 term neonates with a gestational age of 37 to 42 weeks, birth weight of more than 2500 g, and diagnosed with neonatal jaundice. Patients were equally assigned to two groups of phototherapy (wavelength 420-450 nm) with oral probiotics (PediLact drop, 10 drops daily) and phototherapy alone through a simple random sampling method. Serum bilirubin levels (SBL) at the time of intervention, and 24, 48, and 72 hours later, duration of phototherapy, duration of hospitalization, and the need for blood transfusion were compared in the two groups. We used t-test and repeated analysis of variance to compare continuous variables. SPSS24 software was used to analyze the data. The significance level was set as 0.05. Results: There was no statistically significant difference found between the two groups regarding basic variables, gender, birth weight, gestational age, maternal age, and neonatal age at hospitalization time. On the first day of hospitalization, the mean serum bilirubin level (SBL) in the combinatory therapy group was 15.6 ± 1.7 mg/dl, while in the monotherapy group, it was 15.8 ± 1.6 mg/dl (p = 0.584). On the second day, the mean SBL in the combinatory therapy group was 11.2 ± 2.2, whereas in the monotherapy group, it was 12.4 ± 2.1. By the third day, these levels were 7.2 ± 0.9 and 7.8 ± 0.7, respectively, with a statistically significant difference between the two groups. Repeated analysis of variance testing confirmed a statistically significant decrease in serum bilirubin levels in both groups. The average length of hospital stay for the combinatory therapy group was 2.4 ± 0.5 days, compared to 2.8 ± 0.6 days in the phototherapy group (p = 0.001). In terms of phototherapy duration, the combinatory therapy group received treatment for 26.2 ± 9.9 hours, while the phototherapy group received it for 31.4 ± 10.3 hours (p = 0.001). Conclusion: The findings of the present study indicate that incorporating oral probiotics into phototherapy for neonatal jaundice (icterus) treatment is associated with a reduction in phototherapy duration and hospital stay.