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Blinded by the light? Possible phototherapy downsides

Journal of Perinatology volume 40, page 1584 (2020)Cite this article

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I very much appreciated Hansen et al.’s review celebrating 60 years of phototherapy for neonatal jaundice [1]. Two parts of it puzzled me, however. First, the section on adverse effects had important omissions. The authors did not mention concerns about photo-oxidative injury or damage to DNA raised in multiple studies. They also failed to cite recent studies indicating that phototherapy is associated with a small absolute increases in risk of subsequent cancer [2, 3] and epilepsy [4, 5].

The other thing that puzzled me was the first sentence of the abstract, stating that phototherapy has “saved the lives of millions from death and disabilities.” Nothing in the paper supports this statement; I would be interested in the authors’ basis for this estimate.

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References

  1. Hansen TWR, Maisels MJ, Ebbesen F, Vreman HJ, Stevenson DK, Wong RJ, et al. Sixty years of phototherapy for neonatal jaundice - from serendipitous observation to standardized treatment and rescue for millions. J Perinatol. 2020;40:180–93.

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  2. Wickremasinghe AC, Kuzniewicz MW, Grimes BA, McCulloch CE, Newman TB. Neonatal phototherapy and infantile cancer. Pediatrics. 2016;137:e20151353.

  3. Auger N, Laverdiere C, Ayoub A, Lo E, Luu TM. Neonatal phototherapy and future risk of childhood cancer. Int J Cancer. 2019. https://doi.org/10.1002/ijc.32158.

  4. Maimburg RD, Olsen J, Sun Y. Neonatal hyperbilirubinemia and the risk of febrile seizures and childhood epilepsy. Epilepsy Res 2016;124:67–72.

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  5. Newman TB, Wu YW, Kuzniewicz MW, Grimes BA, McCulloch CE. Childhood Seizures After Phototherapy. Pediatrics. 2018;142:e20180648.

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Authors and Affiliations

  1. Professor Emeritus of Epidemiology & Biostatistics and Pediatrics, UCSF, UCSF Box 0560 Mission Hall: Global Health and Clinical Sciences Building 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA

    Thomas B. Newman

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  1. Thomas B. Newman
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Correspondence to Thomas B. Newman.

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TBN has served as a paid consultant for law firms on cases related to neonatal jaundice and for Kaiser Permanente Northern California on research related to newborns. He serves as an unpaid member of an American Academy of Pediatrics Committee that is updating guidelines for management of neonatal jaundice.

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Newman, T.B. Blinded by the light? Possible phototherapy downsides. J Perinatol 40, 1584 (2020). https://doi.org/10.1038/s41372-020-0686-1

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