A STUDY OF UMBILICAL CORD BILIRUBIN AS A PREDICTOR OF SIGNIFICANT NEONATAL JAUNDICE IN A TERTIARY RURAL CARE HOSPITAL

Abstract

Introduction. Around 80 percent of preterm infants and 60 percent of term infants are affected by neonatal jaundice in the first week of life. Early discharge of healthy term infants is a common practice because of economic constraints and social reasons. Which new-borns are at increased risk for developing significant hyperbilirubinemia (Total serum bilirubin ≥ 15mg/dl) is difficult to predict. This study was taken up to evaluate the predictive value of cord blood bilirubin level for identifying term infants for subsequent hyperbilirubinemia. Material and methods. This prospective observational study was conducted in Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka from 1st of April 2020 to 30th September 2020. 100 healthy term babies satisfying the eligibility criteria and born in the study period were included in the study. Umbilical cord blood was collected and was correlated with serum bilirubin levels at 48hours of life. Significant hyperbilirubinemia was taken as ≥ 15mg/dl at 48 hrs of life. Results. The incidence of neonatal hyperbilirubinemia was 14%. By using umbilical cord blood bilirubin ≥ 3mg/dl, significant hyperbilirubinemia can be predicted with Sensitivity of 92.9%, Specificity of 96.5%, Positive Predictive Value of 81.3% and Negative Predictive Value of 98.8%. Conclusion. Umbilical cord blood bilirubin ≥ 3mg/dl in healthy term babies can help in prediction of significant jaundice and thus can help in identifying high risk new-borns so that these neonates can be followed up more closely, it can also help in identifying neonates who are not at increased risk of developing significant jaundice, hence can prevent unnecessary hospital stay.