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Efficacy of oral agar in management of indirect
hyperbilirubinemia in full-term neonates

Research Authors
Safwat M. Abdel-Aziz Ali, Shereen Mansour Galal, Shaban M. Sror, Omima
Hussein, Abd-El-Haseeb Osman Abd-El-Haseeb Ahmed & Enas A. Hamed
Research Department
Research Journal
The Journal of Maternal-Fetal & Neonatal Medicine
Research Publisher
NULL
Research Rank
1
Research Vol
1476-7058
Research Website
NULL
Research Year
2020
Research_Pages
NULL
Research Abstract

Aim: This prospective randomized case control study aimed to investigate effect of oral agar
administration in reducing total serum bilirubin (TSB) levels in full-term neonates with jaundice
in comparison with control.
Materials and methods: One hundred sixty full-term neonates were enrolled with TSB
10–19 mg/dl at first week of age from Assiut University Children’s Hospital. Neonates were divided
according to TSB into outpatient group (n¼100) (TSB 10–15mg/dl) and admitted group
(n¼60) (TSB > 15–19mg/dl). Outpatients group were subdivided into agar group received oral
agar and control group received placebo. Admitted group were subdivided into agar group
received oral agar plus phototherapy combination and control group received phototherapy
alone. Neonates in the agar supplementation received oral agar 600 mg/kg/day dissolved in
10 ml distilled water twice daily till TSB decreased to 7mg/dl. Daily weight, stool frequency and
side effects of treatment were observed for each group. TSB was determined pretreatment then
serially every 48 h until TSB level reaching 7mg/dl.
Results: Agar fed was effective in lowering TSB in neonates with TSB 10–15 mg/dl. TSB percentage
changes were not significantly lower in agar-fed newborn with TSB >15–19mg/dl compared
with control groups after 24 h and 7 days. Age fed shortened the time required to
decrease TSB and increased stooling frequency.
Conclusions: Oral agar supplemented feeding at 600mg/kg/day is safe for full-term neonates
and useful in decreasing TSB and phototherapy duration. The efficacy of phototherapy in
decreasing TSB level in neonatal hyperbilirubinemia can be augmented with oral agar usage.