Is phototherapy a risk factor for ileus in high-risk neonates?

Background. Abdominal distension and bile stained aspirates are common in high-risk neonates under phototherapy (PT). Objective. To compare the incidence of ileus and related risk factors in extremely low birth weight (ELBW) neonates who did/did not receive PT. Design/methods. Retrospective detailed analysis of data on 52 consecutive ELBW neonatal admissions (1997-1999) including demographic characteristics, outcomes to discharge and common risk factors for ileus such as intrauterine growth retardation, PDA, indomethacin therapy, sepsis and enteral feeds. Ileus was defined as presence of abdominal distension and bile stained aspirate/s with/without dilated bowel loops on X-rays. Results. A significantly (p=0.001) higher proportion (63.4%, 26/41) of neonates under PT developed ileus than those (1/11) who did not receive PT. The outcomes and risk factors for ileus were comparable between the two groups. Mean (+/- SD) gestational age and birth weight of those who did and did not receive PT [26 (+/- 2.2) weeks and 803 (+/- 133) grams vs. 27 (+/- 3.2) weeks and 664 (+/- 114.2) grams], and those who did and did not develop ileus [26.5 (+/- 2.3) weeks and 797 (+/- 102) grams vs. 28.0 (+/- 1.2) weeks and 750 (+/- 105) grams] were not significantly different. Conclusion. Phototherapy may be an independent risk factor for ileus in ELBW neonates.