Abstract

Background: Neonatal hyperbilirubinemia is one of the most common clinical conditions encountered during the neonatal period, affecting approximately 60% of term and 80% of preterm infants during the first week of life. Although physiological jaundice is usually self-limiting, severe unconjugated hyperbilirubinemia may progress to acute bilirubin encephalopathy and kernicterus, resulting in permanent neurological disability or death if left untreated. Phototherapy has become the standard treatment for neonatal jaundice because of its effectiveness, non-invasive nature, and excellent safety profile. Nevertheless, increasing experimental evidence has raised concerns regarding possible biological effects of prolonged blue-light exposure on neonatal tissues, particularly the genital organs of male infants. Objective: To critically review current scientific evidence regarding the impact of neonatal phototherapy on genital organs and to discuss evidence-based nursing interventions for ensuring safe and effective phototherapy administration. Methods: A narrative review of the literature was conducted using electronic databases including PubMed, Scopus, Google Scholar, ScienceDirect, MEDLINE, CINAHL, and the Cochrane Library. English-language articles published between 2000 and 2025 were considered. Search terms included neonate, phototherapy, hyperbilirubinemia, genital organs, testicular injury, oxidative stress, reproductive safety, and nursing care. Clinical studies, experimental animal studies, systematic reviews, meta-analyses, and international clinical guidelines were included. Results: Available evidence demonstrates that phototherapy remains a highly effective and safe treatment for neonatal hyperbilirubinemia. Experimental animal studies have reported increased oxidative stress, transient histopathological alterations, and reduced antioxidant enzyme activity within testicular tissue following prolonged light exposure. However, human clinical studies have not demonstrated convincing evidence of permanent impairment of genital development, endocrine function, fertility, or reproductive health. International organizations, including the American Academy of Pediatrics (AAP), the World Health Organization (WHO), and the National Institute for Health and Care Excellence (NICE), continue to recommend phototherapy as the first-line treatment for neonatal hyperbilirubinemia. Appropriate nursing care—including eye protection, institutional genital shielding practices, thermoregulation, hydration, bilirubin monitoring, and parent education—remains essential to maximize therapeutic benefits while minimizing potential risks. Conclusion: Current evidence supports the continued use of phototherapy as the safest and most effective treatment for neonatal jaundice. Although laboratory studies suggest theoretical concerns regarding oxidative injury to genital tissues, available human evidence does not indicate clinically significant long-term reproductive harm. Continued research involving long-term follow-up of exposed infants is warranted to further strengthen the evidence base. Neonatal nurses play a pivotal role in ensuring safe phototherapy administration through vigilant assessment, adherence to evidence-based guidelines, and family-centered care.

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