Lai Yi Chun, Yew Yik Weng
T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
National Skin Centre, Singapore City, Singapore.
Pediatr Dermatol. 2016 Jan-Feb;33(1):62-8. doi: 10.1111/pde.12730. Epub 2015 Dec 8.
Neonatal blue light phototherapy (NBLP) is an established method of managing neonatal hyperbilirubinemia. Approximately 5% of newborns are exposed to NBLP. Evidence of whether NBLP predisposes to the development of melanocytic nevi later in life has been conflicting.
The goal of the current study was to conduct a systematic review and meta-analysis to quantitatively assess the effect of NBLP on melanocytic nevus count.
We searched for observational studies in Medline, EMBASE, and the Cochrane Central Register from their inception to April 15, 2015. Meta-analysis of Observational Studies in Epidemiology guidelines were followed. DerSimonian and Laird random-effects models were used to calculate the weighted mean difference (WMD). Publication bias was assessed using a funnel plot and the Egger's test.
Five studies with a total of 2,921 subjects were included, of whom 642 underwent NBLP. With random-effects modeling, those who had previous NBLP did not have a significantly higher mean number of melanocytic nevi (WMD = 0.32 [95% confidence interval -0.67, 1.31], p = 0.53). Visual inspection of the funnel plot suggested potential publication bias, although the Egger's test (p = 0.09) indicated no small-study effect.
There was no evidence that prior NBLP exposure significantly increased the number of melanocytic nevi. Available evidence has not revealed any cause for major concern for NBLP. Other risk factors such as exposure to sunlight, childhood history of sunburn, and fair skin complexion might play a greater role in the development of melanocytic nevi in childhood.
新生儿蓝光光疗（NBLP）是治疗新生儿高胆红素血症的既定方法。约5%的新生儿接受过NBLP治疗。关于NBLP是否会使个体在日后患黑素细胞痣的证据一直存在争议。
本研究的目的是进行系统评价和荟萃分析，以定量评估NBLP对黑素细胞痣数量的影响。
我们检索了Medline、EMBASE和Cochrane中心对照试验注册库自建库至2015年4月15日的观察性研究。遵循《流行病学观察性研究的荟萃分析指南》。采用DerSimonian和Laird随机效应模型计算加权平均差（WMD）。使用漏斗图和Egger检验评估发表偏倚。
纳入了5项研究，共2921名受试者，其中642人接受过NBLP治疗。采用随机效应模型分析，既往接受过NBLP治疗的受试者黑素细胞痣的平均数量并未显著增加（WMD = 0.32 [95%置信区间 -0.67, 1.31]，p = 0.53）。漏斗图的直观检查提示可能存在发表偏倚，尽管Egger检验（p = 0.09）未显示存在小样本研究效应。
没有证据表明既往接受NBLP治疗会显著增加黑素细胞痣的数量。现有证据未发现NBLP存在重大问题。其他风险因素，如阳光照射、儿童期晒伤史和白皙肤色，可能在儿童期黑素细胞痣的发生中起更大作用。
