Abstract
Objectives: To assess the value of cord blood bilirubin in identifying term healthy babies who develop significant hyperbilirubinemia. Methodology: This Prospective cohort study, conducted from May 2016 to September 2016 in a tertiary care hospital included 100 term healthy breastfed babies without Rh incompatibility or significant illness. Cord bilirubin was estimated in all babies. Neonates were followed up daily for 5 days for hyperbilirubinemia. Serum bilirubin levels were estimated on day 5 in all babies. Significant hyperbilirubinemia was defined as bilirubin > 15 mg/dl after 72 hours. Results: Mean cord bilirubin was 2.8 +2.4 mg /dl in those who developed hyperbilirubinemia and 2.5+2.91 mg/dl in those who did not. Clinically detectable jaundice was present in 72%.Twenty-two percent babies developed hyperbilirubinemia. Peak serum bilirubin of babies who developed significant hyperbilirubinemia was 23+ 2.8mg/dl at 120 hours. Cord bilirubin of > 2mg /dl was present in 64 babies and 19 (29%) developed hyper bilirubinemia. Cord bilirubin 2mg/dl. ABO incompatibility was significantly associated with hyperbilirubinemia (p=0.0006). Conclusion: Cord bilirubin can be a good predictor of hyperbilirubinemia. Neonates with cord bilirubin 2 mg/dl need close follow up.
Highlights
Clinical jaundice is seen in 60-70% of term and about 80% of preterm newborns [1]
Neonatal jaundice is a benign condition observed during the first week of life.Hyperbilirubinemia in the newborn usually peaks between 3 and 7 days of age
Higher cord bilirubin levels among infants who develop significant hyperbilirubinemia as compared to nonhyperbilirubinemic infants indicate that mechanisms of subsequent jaundice are already active in fetal life.most fetal bilirubin is unconjugated and in plasma is totally bound to albumin
Summary
Clinical jaundice is seen in 60-70% of term and about 80% of preterm newborns [1]. Various methods have been suggested for prediction of neonatal jaundice such as physical examination, evaluation using risk factor table, routine predischarge transcutaneous bilirubin measurement and measuring expiratory carbon monoxidelevels. American Academic of Pediatrics (AAP) recommends that newborns discharged within 48 hours should have a follow-up visit after 48 to 72 hours for any significant jaundice or other problems [3]. This is not possible in India due to limited follow-up facilities. Family and traditional beliefs have led to early discharge of healthy term neonates after delivery
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Pediatric Review: International Journal of Pediatric Research
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
