Abstract
Introduction: Hyperbilirubinemia is a common problem among term newborns. Cord bilirubin level has been found to correlate well with day 3 bilirubin level. We studied whether cord bilirubin could predict risk of development of significant hyperbilirubinemia among term neonates. Methodology: Prospective study from October 2009 -July 2010. All newborns between 37 weeks -42weeks, birth weight > 2500 gram, Apgar score > 7 at 1st& 5th minute of life were included in the study. Cord blood, day 3 & day 5 bilirubin was collected. Maternal data & bilirubin values were collected & analyzed using SPSS software. Results: About 115 babies were studied. There was no significant difference in cord bilirubin & day 3 bilirubin between babies born to mothers 30 years. There was no significant difference in bilirubin values bassed on mode of delivery. About 29.6% babies developed clinical jaundice & received phototherapy. Cord bilirubin levels had significant association with need of phototherapy. Cord bilirubin >/= 2.1 mg/dl predicted need for phototherapy with PPV of 90.3%. Maternal age, sex of baby, birth weight & gestational age had no significant effect on cord bilirubin levels. Cord bilirubin >/= 2.1 mg/dl predicted day 3 serum bilirubin > 15 mg/dl with sensitivity of 88 % & PPV of 77.49 %. The likelihood ratio with cord bilirubin > 2.1 mg/dl & day 3 serum bilirubin > 15 mg/dl was 9.316. Conclusion: Cord bilirubin is predictive of need of phototherapy & correlated well with day 3 bilirubin levels which would facilitate early management of neonatal hyperbilirubinemia.
Highlights
Hyperbilirubinemia is a common problem among term newborns
Cord bilirubinlevel is being increasingly studied to define a subgroup of newborns that are at higher risk for developing significant hyperbilirubinemia
Analysing the bilirubin values based on maternal age, there was no statistically significant difference in the cord bilirubin level & day 5 bilirubin in babies born to mothers < 30 years of age when compared to mothers > 30 years of age
Summary
Hyperbilirubinemia is a common problem among term newborns. Cord bilirubin level has been found to correlate well with day 3 bilirubin level. We studied whether cord bilirubin could predict risk of development of significant hyperbilirubinemia among term neonates. There was no significant difference in cord bilirubin & day 3 bilirubin between babies born to mothers < 30 years &> 30 years. Sex of baby, birth weight & gestational age had no significant effect on cord bilirubin levels. Conclusion: Cord bilirubin is predictive of need of phototherapy & correlated well with day 3 bilirubin levels which would facilitate early management of neonatal hyperbilirubinemia. Common factors responsible for hyperbilirubinemia among term babies include increased bilirubin load due to relative polycythemia, shortened erythrocyte life span, immature hepatic intake & conjugation processes along with increased enterohepatic circulation. Cord bilirubinlevel is being increasingly studied to define a subgroup of newborns that are at higher risk for developing significant hyperbilirubinemia. This study was done to assess cord bilirubin as a predictor of neonatal hyperbilirubinemia
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