Published: 2020-03-21

A study to determine the level of cord blood albumin in predicting neonatal jaundice

Usha Hirevenkanagoudar, Pranam G. M., Sanjeev Chetty


Background: Most unconjugated bilirubin formed by the fetus is cleared by the placenta into the maternal circulation. Albumin constitutes 70 - 75% of Plasma oncotic pressure. Another important function of albumin is its antioxidant property. Bilirubin binds to albumin in an equimolar ratio. Free bilirubin is anticipated when the molar bilirubin- to- albumin (B: A) ratio is >0.8 Objective of the study was to predict the proportion of newborn requiring intervention for NH (phototherapy or exchange transfusion) based on cord serum albumin level at birth.

Methods: The present prospective study was conducted at Navodaya Medical College, Raichur from October 2018 to November 2019. A total of 180 babies which were born during the study period were included in the study. INCLUSION CRITERIA• Term babies both genders• Mode of delivery (normal and C-section)• Birth weight ≥2.5kg.• APGAR ≥7/10 at 1 min. Cord Serum Albumin level was estimated at birth. Total Serum Bilirubin (TSB) estimation was done at 72-96 hours of age. All the babies were followed up daily for first 4 postnatal days and babies were daily assessed for NH and its severity.

Results: In our study nearly 54.4% of them had Cord Serum Albumin levels of less than 2.8 gm/dl, 27.3% of them had albumin levels of 2.9 to 3.3 gm/dl, 18.3% of them had Serum Albumin of 3.4 gm/dl. Out of 180 study subjects, 13.9% of them required phototherapy to treat neonatal hyper bilirubinemia and 2.8% of the study subjects required exchange transfusion.

Conclusions: From the present study, cord serum albumin level of ≤2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So, this ≤2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia.


Bilirubin, Albumin, Jaundice, Neonate, Predictor

Full Text:



Cloharty JP, Stork AR, Eichenwald EC, Hansen AR. Manual of neonatal care. Chapter 26, Neonatal Hyperbilirubinemia. 7th edn. Philadelphia: Lippincott Willams and Wilkins; 2012:304-339.

Guruprasad G. Bilirubin Metabolism- what we should know? J Neonatol. 2001;1:4-7.

Madan A, James RM, Stevenson DK. Neonatal Hyperbilirubinemia. In: Taeusch HW, Ballard RA, Gleason CA. Avery's diseases of the new born. 8th Ed. Philadelphia: Elsevier Saunders; 2004:1226-1256.

Kliegman RM, Behrman RE, Stanton BF, Schor.NF. Jaundice and Hyperbilirubinemia in the Newborn. Nelson textbook of Pediatrics. 19th ed. Philadelphia: Saunders; 2012:603-608.

Whitington PF, Alonso EM. Disorder of Bilirubin Metabolism. In: Nathan DG, Orkin SH, Ginsberg D, Thomas LA. Hematology of Infancy and Childhood. 6th edn. Philadelphia: Saunders Company; 2003:86-120.

Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatr. 1998 Jun 1;101(6):995-8.

Taksande A, Vilhekar K, Jain M, Zade P, Atkari S, Verkey S. Prediction of the development of neonatal hyperbilirubinemia by increased umbilical cord blood bilirubin. Ind Medica. 2005;9(1):5-9.

Rostami N, Mehrabi Y. Identifying the newborns at risk for developing significant hyperbilirubinemia by measuring cord bilirubin levels. J Arab Neonatal Forum. 2005;2:81-5.

Randew S, Grower N. Predicting neonatal hyperbilirubinemia using first day serum bilirubin levels. Indian J Pediatr. 2010;77:147-50.

Alpay F, Sarici SÜ, Tosuncuk HD, Serdar MA, Inanç N, Gökçay E. The value of first-day bilirubin measurement in predicting the development of significant hyperbilirubinemia in healthy term newborns. Pediatr. 2000 Aug 1;106(2):e16.

Palmer DC, Drew JH. Jaundice a 10-year review of 41000 live born infants. Aust Pediatr. 1983;19(2):86-9.

Agarwal R, Deorari AK. Unconjucated Hyperbilirubinemia in Newborn. Indian Pediatr. 2002;17(39):30-42.

Sahu S, Abraham R, John J, Mathew MA, Res M. Cord blood albumin as a predictor of neonatal jaundice. Int J Biol Med Res. 2011;2(1):436-8.

Trivedi DJ. Cord serum bilirubin and albumin in neonatal hyperbilirubinemia. Int J Int Sci Inn Tech Sec A. 2013;2(2):39-42.