Aim: To study rebound hyperbilirubinemia in post-phototherapy neonates. Methods: A prospective observational study was conducted in pediatric tertiary care hospital. 156 neonates were recruited in the study and phototherapy was given according to guidelines. After consent, detailed history was taken and clinical examination were carried out for both groups. They were subsequently estimated for rebound hyperbilirubinemia usually 24±6 hrs after cessation of phototherapy. Serum bilirubin (total and direct) was measured at the end of phototherapy, after 24±6 hours of stopping phototherapy. Results: Statistically significant association found with risk factors include gestational age <35 weeks (p value 0.004), low birth weight (<2000gms) (p =0.047),, haemolytic causes(p value <0.001), age at onset of jaundice, duration of primary phototherapy <72 hrs(p value of 0.034). 50% neonates recovered within 24-48hours of phototherapy & 44.4% required phototherapy for ≥48 hours. This result bears significant statistical correlation (p value 0.002).The mean duration of hospital stay is 5.32 ± 1.85 days and it was observed that majority of babies (56.4%) with significant post-phototherapy rebound hyperbilirubinemia had stayed for 5-8 days in the hospital before discharge. Conclusion: In this study it is found that rise of serum bilirubin to a significant level after phototherapy cessation is present in 11.5% of cases. The etiological risk factors include gestational age <35 weeks, low birth weight (<2000gms), haemolytic causes, age at onset of jaundice, duration of primary phototherapy <72 hrs. Retreatment with phototherapy was found to be an effective therapy for neonates with significant post phototherapy rise of serum bilirubin.

Keywords: Phototherapy; Rebound Hyperbilirubinemia; Serum Bilirubin.