Association of cord serum albumin with neonatal hyperbilirubinemia among term-neonates

Abstract

Background: NH affects nearly 60% of term and 80% of preterm neonates during first week of life. 6.1% of well term newborn have a serum bilirubin over 12.9 mg%. Serum bilirubin over 15 mg% is found in 3% of normal term newborns. Neonatal Hyperbilirubinemia (NH) is a cause of concern for the parents as well as for the paediatricians. Aim of study to find out the association between various levels of cord serum albumin (CSA) and significant neonatal hyperbilirubinemia requiring interventions like phototherapy or exchange transfusion and whether it can be used as a risk indicator for subsequent development of significant jaundice.Methods: The present study was conducted on 150 randomly selected eligible term neonates delivered at Department of Pediatrics, Rajkiya Mahila Chikitsalaya, JLN Medical College and Associated Group of Hospitals, Ajmer, India.Results: Authors conducted a prospective study on 150sequentially born term babies. Cord blood was collected at birth and cord serum albumin estimation was done within 4-6 hours of collection of the blood. Cohort was grouped into Group 1, Group 2 and Group 3 based on CSA level ≤ 2.8g/dl, 2.9-3.3g/dl and ≥ 3.4 g/dl respectively. Knowledge of risk factors of NH in neonates could influence decision of early discharge vs. prolonged observation cord serum albumin level of ≤ 2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So this ≤ 2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia. Whereas cord serum albumin level ≥3.4g/dl is considered safe.Conclusions: Term neonates with hyperbilirubinemia with a total serum bilirubin level ≥17 mg/dl had levels of cord serum albumin of ≤ 2.8 g/dl, and this can be used as a risk indicator to predict the development of NH.