Prediction of neonatal hyperbilirubinemia using first day serum bilirubin level

Lalat Barun Patra


Background: The new born needs the utmost care for all the neonatal problems for its better outcome in the future and neonatal hyperbilirubinemia is one of them and with its timely detection and management a good prognosis can be predicted. The main objective is utility of first day serum bilirubin level in predicting subsequent development of neonatal hyperbilirubinemia in term and near term babies.  It is a Prospective study Design. Setting :Tertiary care medical college.

Methods: Total of 213 babies was included in the study. Sick and Rh incompatible babies were excluded. Serum bilirubin estimated on day1 of life and subsequently repeated on day3 and day5 in whom 1st day value was more tan 6mg/dl, statistical analysis was done.

Results: The risk of subsequent development of hyperbilirubinemia is <1% compared to 27.2% when 1st day bilirubin level was <6mg/dl or >6mg/dl (p<0.01). The incidence was much less in exclusive breastfed babies. Male preponderance was seen. Vaginally delivered babies were more prone to develop jaundice later compared to babies born by LSCS (P<0.003). Sensitivity was 100% and specificity was 60% in picking babies who required phototherapy for high bilirubin values.

Conclusions: Mean serum bilirubin level of 6 mg/dl in the first 24 hours of life was determined to have the highest sensitivity to predict the new-borns that would develop significant hyperbilirubinemia. There were no significant differences between the cases who did and who did not develop significant hyperbilirubinemia with respect to various risk factors.


Neonatal hyperbilirubinemia, First day serum bilirubin, Term neonates

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