A Comparative Study of Cord Blood Bilirubin and Albumin as a Predictor for Neonatal Jaundice in Term Newborns

Abstract

Background: Neonatal hyperbilirubinemia (NH) is the commonest abnormal physiological finding during the 1st week of life. More than two-third of newborn babies develop clinical jaundice. The clinical finding such as yellowish discoloration of the skin and sclera in newborns is because of accumulation of unconjugated bilirubin. In most infants, however, unconjugated hyperbilirubinemia is a normal physiological phenomenon. Aim of the Study: The aim of the study was to predict the development of NH at birth in term newborns using cord blood bilirubin and albumin as a risk predictor. Materials and Methods: The present cross-sectional study was performed on 150 healthy term newborns, i.e., both males (n = 84) and females (n = 66) with gestational age >38 weeks delivered by caesarian section from the Department of Obstetrics and Gynaecology and Department of Pediatrics and Department of Biochemistry, Santosh Medical College, Ghaziabad. Results: Cord serum albumin (CSA) level of ≤2.8 g/dl cutoff value is chosen based on the receiver operating characteristics (ROC) analysis. Shows the neonates who developed NH, 95.2% of these cases had CSA level ≤2.8 g/dl (20/21). If CSA level ≤2.8 g/dl, 28.9% probability of developing NH, and if CSA >2.9 g/dl, then 97.7% chance of not developing NH. Similarly, if CSA level ≥3.4 g/dl, nil or 0% chance of developing NH. Hence, CSA level ≤2.8 g/dl can be considered as critical value or risk factor for the development of NH, whereas newborn with CSA level ≥3.4 g/dl is safe for early discharge. Conclusion: Increasing incidence of kernicterus in healthy term neonates as Kernicteus is the chronic sequelae of acute bilirubin encephalopathy. Hyperbilirubinemia is one of the most common causes for readmission of the newborns. Incidence of kernicterus is unknown. Hence, defining a certain bilirubin level as physiological can be misleading and potentially dangerous. NH is a potentially correctable and kernicterus is preventable.