Efficacy and safety of home-based fiberoptic blanket versus hospital-based light-emitting diode phototherapy for neonatal jaundice: a retrospective cohort study from Thailand.

BACKGROUND

Home phototherapy (HPT) is an alternative to inpatient phototherapy (IPT) for the treatment of neonatal jaundice; however, comparative data remain limited on the effectiveness of phototherapy (PT) devices across care settings.

PURPOSE: To compare the efficacy and safety of HPT using a fiberoptic light-emitting diode (LED) PT blanket with those of IPT using overhead LED PT in neonates with jaundice.

METHODS

This retrospective cohort study included neonates born at ≥35 weeks' gestation who were prescribed treatment for jaundice at a tertiary academic medical center in Thailand between August 1, 2023, and December 31, 2025. Infants who underwent either HPT or IPT were included. The bilirubin reduction, treatment success, and adverse event rates were compared between groups.

RESULTS

A total of 100 PT sessions (89 neonates) were analyzed, including 55 HPT sessions (50 infants) and 45 IPT sessions (43 infants). Some infants received both treatment modalities during separate sessions, and each session was analyzed according to the administered PT modality. The mean bilirubin reduction rate was significantly lower in the HPT versus IPT group (0.18±0.10 mg/dL/hr vs. 0.29±0.08 mg/dL/hr, P<0.001). This finding remained consistent in uni- and multivariate multilevel mixed-effects linear regression analyses, accounting for repeated PT sessions, intergroup crossover, and potential confounders (coefficient, -0.116; 95% confidence interval, -0.146 to -0.086; P<0.001). Treatment success was achieved in all infants except for one in the HPT group who experienced an increase in total serum bilirubin following treatment that subsequently resolved after conversion to IPT. No serious PT-related complications were observed in either group.

CONCLUSION

In routine clinical practice, fiberoptic home PT was safe but less effective than hospital-based LED PT at reducing bilirubin levels, supporting its use in carefully selected neonates with appropriate monitoring and follow-up.