To Assess Predictive Value of Cord Blood Bilirubin and Albumin for Significant Neonatal Hyperbilirubinemia: A Prospective Study from India

Abstract

Aim: To assess the usefulness of the cord blood bilirubin and cord albumin estimation as a predictor of subsequent neonatal hyperbilirubinemia in a healthy term infants and to compare their predictive abilities: a prospective study. Material and Method: This study enrolled 200 full term neonates during the study period. Bilirubin and albumin estimation was done from cord blood, 1st day, 3rd day and 5th day bilirubin estimation was done from peripheral venous blood. Relationship was seen between level of albumin and bilirubin. Result: Cord blood bilirubin level of >2 mg/dl had a sensitivity of 90% and specificity of 53.89%, positive predictive value 17.8% and negative predictive value of 98% in predicting the risk of neonatal hyperbilirubinemia. (p<.001). Cord blood albumin level of ≤2.6 gm/dl had a sensitivity of 80% and specificity of 86.67%, positive predictive value 40% and negative predictive value of 97.5% in predicting the risk of neonatal hyperbilirubinemia (p<.0001) 1st day bilirubin level of ≥5.7 mg/dl had a sensitivity of 90% and specificity of 82.22%, positive predictive value of 36% and negative predictive value of 98.7% in predicting the risk of neonatal hyperbilirubinemia(p<.0001). Conclusion: Cord bilirubin and albumin can be used as predictor for hyperbilirubinemia and for early review for jaundice especially in developing countries where regular follow up is difficult.