What question did this study set out to answer?

This research aims to determine if ursodeoxycholic acid (UDCA) enhances the effectiveness of phototherapy in treating neonatal indirect hyperbilirubinemia.

June 19, 2026Open Access

Effect of Ursodeoxycholic Acid in lowering neonatal indirect hyperbilirubinemia

Key Points

This research aims to determine if ursodeoxycholic acid (UDCA) enhances the effectiveness of phototherapy in treating neonatal indirect hyperbilirubinemia.
Conducted a randomized controlled trial in a Neonatal Care Unit; enrolled 200 neonates with indirect hyperbilirubinemia.
Participants were randomly assigned to receive either UDCA plus phototherapy or phototherapy alone.
Used computer-generated randomization with concealed allocation and blinded outcome assessment.
In Group A, bilirubin levels reduced significantly to 7.6 mg/dL by 36 hours (mean total bilirubin 7.6 mg/dL).
Group B’s bilirubin levels fell more slowly, reaching 9.1 mg/dL at 48 hours (mean total bilirubin 9.1 mg/dL).
Average phototherapy duration was 23.2 hours in Group A compared to 41.1 hours in Group B, indicating a reduction by about one day.

Abstract

Background: Neonatal hyperbilirubinemia is one of the most frequent conditions in newborns. Around 60% of term and nearly 80% of preterm infants show visible jaundice during the first postnatal week.Aim: This study evaluated whether adding ursodeoxycholic acid (UDCA) to conventional phototherapy accelerates the decline of indirect bilirubin in neonates.Methods: A randomized controlled trial was carried out in the Neonatal Care Unit at Sulaimani Pediatric Teaching Hospital between February 2014 and February 2015. Two hundred neonates with indirect hyperbilirubinemia were enrolled and randomly assigned to: - Group A (n=100): Oral UDCA 10 mg/kg/day in two divided doses plus phototherapy. - Group B (n=100): Phototherapy alone.Randomization used a computer-generated block sequence (block size 4). Allocation was concealed in sealed opaque envelopes. Outcome assessors were blinded.Results: In Group A, mean total bilirubin declined to 11.7 ± 1.5, 8.8 ± 1.1, and 7.6 ± 0.9 mg/dL at 12, 24, and 36 hours, respectively. In Group B, bilirubin fell more slowly: 14.6 ± 1.6, 13.2 ± 5.8, 10.2 ± 1.4, and 9.1 ± 0.8 mg/dL at 12, 24, 36, and 48 hours. The average phototherapy duration was 23.2 ± 5.6 hours in Group A versus 41.1 ± 7.2 hours in Group B.Conclusion: The addition of UDCA to phototherapy significantly hastened bilirubin reduction and shortened treatment duration by about one day compared with phototherapy alone.Keywords: Neonatal jaundice, Indirect hyperbilirubinemia, Phototherapy, Ursodeoxycholic acid.

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