Cord serum bilirubin as a predictor of neonatal hyperbilirubinemia in healthy term and late preterm neonates

Ramanathan R., Baby Praveena A.


Background: Icterus neonatorum is the most common neonatal illness occurring in the first 7 days of life. It is the most important cause for hospital readmissions during the early neonatal period and also the cause for neonatal morbidity. In this study our main objective is, to find out that whether detecting umbilical cord blood bilirubin levels soon after birth, will help to identify the development of significant jaundice in early neonatal period which requires immediate intervention

Methods: This was a prospective observational study carried out among 150 term and preterm babies. Their cord bilirubin level were estimated. Jaundice was determined by using yellowish appearance of eyes, skin and Kramer score. Statistics employed include Chi-square test and receiver operator characteristic curve

Results: Study participants enrolled into the study was 150. Cord serum bilirubin was significantly associated with Kramer score and yellowish discoloration of eyes and skin and not significantly associated with sex, mode of delivery, gestational age and birth weight. When cord serum bilirubin was compared against the occurrence of clinical jaundice, sensitivity was found to be 58.33%, specificity was 96.49% positive predictive value was 84% and negative predictive value was 88%. Receiver operator characteristics curve indicated that the area below the curve was 0.842.

Conclusions: Cord serum bilirubin can be used as a screening tool to identify the neonatal jaundice in both term and late preterm babies. Present study has shown increased specificity than sensitivity which warrants further exploration.


Cord blood bilirubin, Neonatal hyperbilirubinemia, Predictive value, Sensitivity, Specificity

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