The Effect of Clofibrate With Phototherapy on Full-Term Newborns With Non-Hemolytic Jaundice

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hyperbilirubinemia is a common problem in Iranian newborns and constitutes approximately one third of admissions to our neonatal ward. Phototherapy is the most widely used form of therapy for the treatment of neonatal hyperbilirubinemia (1). There are some pharmacological agents introduced for treatment of un-conjugated neonatal jaundice, such as Phenobarbital, Metalloporphyrins, and D–penicillaminem but more research is necessary to prove their safety in clinical use (2). Glucuronyl transferase activity can be increased with administration of clofibrate (3). Therefore, this drug has been recently proposed for the treatment of neonatal hy-perbilirubinemia (4, 5) but, it has not yet been approved as a routine drug for treatment of neonatal jaundice. The aim of the present study was to determine the effect of 100 mg/kg clofibrate on Total serum bilirubin (TSB) level in healthy term neonates. After receiving written consent from the parents, 100 neonates with hyperbilirobinemia were enrolled in this study. Inclusion criteria were body weight between 2500-3500grams, gestational age between 38 to 41 weeks, breastfed, and having TSB between 17 to 22 mg/dl, postnatal age between 3-7 days. Neonates with any congenital anomaly, hemolytic disease (Rh or ABO incompatibility and a positive combs' test), infection (congenital or acquired), dehydration, G6PD deficiency and conjugated bilirubin more than 1/5mg/dl or exceeding 15% of total serum bilirubin were excluded. In this open labeled study, patients were randomly allocated to the treatment group (clofibrate) or the control group by a simple randomization method using a table of random numbers. All neonates in both groups received phototherapy. Each phototherapy unit contained 4 special white lamps and was adjusted 20 cm above the neonatal cot. The lamps were changed regularly after 250 hours of usage. A single dose of clofibrate (100 mg/kg) was administered orally to infants in the study group within 12 hours of admission. Phototherapy was started immediately on admission for all studied patients until TSB decreased to a safe level (< 14 mg/dl). Total and direct serum bilirubin levels were measured 12, 24, 48 and 72 hours after admission and then it was done daily until phototherapy was discontinued. TSB measurement was performed on the basis of spectrophotometric principles by using Bilimeter 3, Pfaff Medical GmbH, and direct bilirubin measurement, by using Auto-analyzer Random Access (Selectra E, Vital Scientific , Netherlands), respectively. Laboratory tests, including complete blood …