Luaran Berat Badan Pada Neonatus Yang Menjalani Fototerapi Berulang

Istiqomah Katin, Dr. dr. Titis Widowati, Sp.A(K)

2026 | Tesis | S2 Kedokteran Klinik

Latar Belakang: Fototerapi merupakan terapi utama pada neonatus dengan hiperbilirubinemia. Pada sebagian kasus, kadar bilirubin dapat meningkat kembali setelah fototerapi dihentikan sehingga diperlukan fototerapi ulang. Kondisi ini menimbulkan kekhawatiran mengenai potensi perubahan berat badan, sementara bukti mengenai luaran berat badan pada fototerapi berulang di Indonesia masih terbatas.

 Tujuan: Mengetahui hubungan antara fototerapi berulang terhadap luaran berat badan pada neonatus dengan hiperbilirubinemia.

 Metode: Penelitian kohort retrospektif dilakukan di RS Sardjito pada neonatus dengan hiperbilirubinemia usia gestasi ?35 minggu selama periode 1 Januari 2023–31 Desember 2024. Subjek diambil secara consecutive sampling dari rekam medis dan dibagi menjadi kelompok fototerapi berulang dan tidak berulang (masing-masing 80 neonatus). Luaran utama adalah perubahan berat badan (%) dalam 24 jam setelah fototerapi terakhir dihentikan.

 Hasil: Rerata berat badan neonatus sebelum fototerapi 2501 ± 569 gram dan setelah fototerapi 2455 ± 537 gram, yang menunjukkan penurunan ringan. Median perubahan berat badan pada kelompok fototerapi berulang lebih kecil dibanding kelompok tanpa fototerapi berulang (?0,21% vs ?2,51%; p < 0 xss=removed>p = 0,008), sedangkan jumlah intake selama fototerapi berhubungan dengan penurunan berat badan yang lebih kecil (B = 0,018; IK 95% 0,005–0,030; p = 0,007). Variabel jenis fototerapi, jenis intake, penggunaan alat penghangat, sepsis, penyakit jantung bawaan, serta usia gestasi tidak berhubungan bermakna setelah dikontrol.

Kesimpulan: Penurunan berat badan pasca fototerapi pada neonatus dengan hiperbilirubinemia umumnya ringan. Fototerapi berulang tidak meningkatkan penurunan berat badan, namun besarnya perubahan lebih dipengaruhi oleh berat lahir dan kecukupan intake. Pemantauan berat badan harian dan optimasi intake cairan selama fototerapi perlu menjadi bagian penting tata laksana, terutama pada bayi dengan berat lahir lebih berat atau yang memerlukan fototerapi berulang.

Background: Phototherapy remains the primary therapeutic modality for neonatal hyperbilirubinemia. In some cases, bilirubin levels rise again after phototherapy is discontinued, necessitating repeat phototherapy. This condition raises concerns regarding potential changes in body weight, while evidence on weight outcomes associated with repeat phototherapy in Indonesia remains limited.

 Objective: To determine the association between repeat phototherapy and post phototherapy weight outcomes in neonates with hyperbilirubinemia.

 Methods: A retrospective cohort study was conducted at Sardjito Hospital, Yogyakarta, including neonates with hyperbilirubinemia and gestational age ?35 weeks treated between January 1, 2023 and December 31, 2024. The primary outcome was percentage weight change within 24 hours after cessation of the last phototherapy session.

 Results: Mean body weight decreased slightly from 2501 ± 569 g before phototherapy to 2455 ± 537 g after phototherapy. The median percentage weight change was smaller in the repeat phototherapy group compared with the non-repeat group (?0.21% vs ?2.51%; p < 0>In multivariate analysis, higher birth weight was independently associated with greater weight loss (B = ?1.109; 95% CI ?1.927 to ?0.290; p = 0.008), whereas higher intake during phototherapy was associated with smaller weight loss (B = 0.018; 95% CI 0.005–0.030; p = 0.007). Phototherapy type, feeding type, warming device use, sepsis, congenital heart disease, and gestational age were not independently associated with weight change.

 Conclusion: Post phototherapy weight loss in neonates with hyperbilirubinemia is generally mild. Repeat phototherapy is not associated with greater weight loss, instead of weight change is more strongly influenced by birth weight and adequacy of intake during phototherapy. Routine daily weight monitoring and individualized optimization of fluid and caloric intake should be integrated into phototherapy care, particularly for neonates requiring repeat phototherapy.

Kata Kunci : neonatal hyperbilirubinemia; repeat phototherapy; weight change; fluid intake