To study the effectiveness of cord blood Albumin as a predictor of neonatal jaundice

Abstract

Background: Neonatal hyperbilirubinemia is one of the commonest problems in newborn. It can be due to different etiologies. Most often it is physiological jaundice. The main reasons for physiological jaundice is that in an infant the liver is not mature enough to handle the freely circulating bilirubin due to higher volume of short life erythrocytes in the circulation and low level of albumin. Early detection of neonatal jaundice is essential to prevent developing kernicterus as well as discharge the babies early. Albumin is synthesized by liver and helps in the transport of unconjugated bilirubin by binding to bilirubin it and thus making it nontoxic to the body. Low levels of albumin make bilirubin free and toxic to the body. Hence, this study was done to evaluate effectiveness of cord blood albumin as a predictor of neonatal Hyperbilirubinemia.Methods: 50 term healthy newborns were included in the study with the term babies of both genders from any mode of delivery, birth weight >2.5 kg, APGAR score more than 7 at 1st and 5th minutes of life and without Rh incapability. Cord blood albumin levels were measured. Blood test for bilirubin was done when required and baby was managed accordingly.Results: Out of the total 50 neonates enrolled, 7 belonged to group 1 (albumin <2.8 g/dl), 34 to group 2 (2.8-3.3 g/dl), and 9 to group 3 (>3.3 g/dl). Out of the total 7 neonates in group 1, 6 (85.71%) was icteric at 24-48 hours and 1 (14.29%) was icteric at >72 hours. All the 7 neonates developed Hyperbilirubinemia requiring phototherapy. 3 (42.86%) out the 7-neonate required phototherapy for more than 24 hours. Out of the total 34 neonates in group 2, 20 (58.82%) was icteric at >72 hours, 12 (35.29%) at 48-72 hours and 2 (5.88%) at 24-48 hours. Only 12 (35.29%) neonates had Hyperbilirubinemia requiring phototherapy. Out of the total 9 neonates in group 3, 1 was icteric at 48 - 72 hours and 8 was icteric at >72 hours. But only 2 had Hyperbilirubinemia requiring phototherapy.Conclusions: Cord blood albumin is an effective way to predict neonatal Hyperbilirubinemia in term healthy infants.