Predictive value of serum bilirubin level for identifying term neonates at risk for subsequent hyperbilirubinemia

Abstract

Background: Infants who are clinically jaundiced in the first few days are more likely to develop hyperbilirubinemia. The present study was made attempt to evaluate the predictive value of serum bilirubin level on day one postnatal age for identifying term neonates at risk for subsequent hyperbilirubinemia.Method: The present hospital based prospective study involving neonate’s ≥37 weeks of gestational age included 200 healthy term newborn babies (≥37weeks GA) born at GSL medical college and hospital at Rajahmundry during study period. The purpose of this study was explained to the parents/ guardian and written consent was taken prior to the study. Data collected was kept securely. Permission was obtained from the Ethical Committee of GSL medical College before starting the study.Result: Newborns who developed significant hyperbilirubinemia male: female ratio was 1.07:1. 9(33%) newborns with significant hyperbilirubinemia had jaundice in previous siblings. In the present study, the value of 4.9 mg/dl was determined to have the best combination of sensitivity and specificity to predict neonates at risk of hyper birubinemia subsequently. At this value of 4.9 mg/dl there is high sensitivity and a very high negative predictive value, although a low positive predictive value for predicting neonates likely to develop significant hyperbilirubinemia.Conclusion: Early screening and appropriate management of hyperbilirubinemia is needed for prevention of complications in the newborn. This decreases the significant burden of untreated severe neonatal jaundice, causing potential neurological sequelae. Prediction of neonatal hyperbilirubinemia has widespread implication especially in our country where there are limited resources.