A prospective study on correlation of cord blood bilirubin with occurrence of neonatal hyperbilirubinemia

Abstract

Background: Neonatal hyperbilirubinemia is one of the most common problems that can occur in a healthy new-born. This physiological rise in indirect component of bilirubin resolves gradually without any intervention in majority of cases. But few babies require intervention in the form of phototherapy and exchange transfusion when the bilirubin levels exceed the normal physiological range for gestational age. The study was aimed to evaluate the predictive value of cord blood bilirubin level for identifying newborn for development of significant hyperbilirubinemia. Methods: It was a prospective observational study carried out in Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Karnataka. The cord blood bilirubin at birth and 48 hrs serum bilirubin levels were measured. Also, blood group, Rh status and DCT (direct coomb’s test) were tested to estimate the risk in development of hyperbilirubinemia. Results: A total of 210 were included in the study, out of which 52 babies required phototherapy, with a sensitivity of 94.23% and specificity of 3.97%, with the mean cord blood bilirubin level of 2.6mg/dl, having sensitivity of 63.46% and specificity of 90.50%. The multivariate analysis showed ABO and Rh incompatibility, cord blood bilirubin level and lower gestational age had an increased the risk of hyperbilirubinemia requiring phototherapy. Conclusions: Cord blood bilirubin may be used as a potential tool to determine hyperbilirubinemia in newborns. And initiation of phototherapy early in at-risk neonates may decrease the hyperbilirubinemia related morbidity and mortality. Keywords: hyperbilirubinemia; cord blood bilirubin; phototherapy; newborn