Association of neonatal hyperbilirubinemia with cord albumin among term appropriate for gestational age neonates

Shweta K. Shah; Anand K.  Jha; Satish Sharma; Sanjay Gupta

doi:10.18203/2349-3291.ijcp20233597

Authors

Shweta K. Shah Department of Pediatrics, National Medical College of Medicine, Birgunj, Parsa, Nepal
Anand K. Jha Department of Pediatrics, National Medical College of Medicine, Birgunj, Parsa, Nepal
Satish Sharma Department of Pediatrics, Seti Provincial Hospital, Dhangadi, Kailali, Nepal
Sanjay Gupta Pokhariya Hospital, Pokhariya, Parsa, Nepal

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233597

Keywords:

Cord serum albumin, Neonatal hyperbilirubinemia, Prediction and newborns

Abstract

Background: Neonatal hyperbilirubinemia (NH) is the most common abnormality seen during the neonatal period. It affects nearly 60% of term and 80% of preterm neonates during the first week of life. Early discharge of healthy term and late preterm newborns after normal vaginal delivery is a common practice however there are reports of bilirubin induced brain damage (kernicterus) occurring in these infants. Therefore, to ascertain whether cord albumin can be used as a reliable indicator for predicting neonatal hyperbilirubinemia.

Methods: A tertiary care hospital-based cross-sectional study was conducted in 142 healthy late preterm and term newborns of either gender with icterus appearing only after 24 hour of life with no other illness using a non-probability sampling method. Data analysis was done using statistical package for the social sciences (SPSS) version 16. Chi-square was used to determine the association between cord albumin and hyperbilirubinemia.

Results: There is a significant negative correlation between cord albumin and serum bilirubin at 72-96 hours of life (p=0.001). A total of 142 healthy late preterm and term neonates included. The study group based on Cord serum albumin (CSA) levels ≤2.8 g/dl, 2.9-3.3 g/dl, and ≥3.4 g/dl shows 77.27%, 22.7% and none respectively developed NH requiring phototherapy. According to receiver operating curve (ROC) analysis, the cutoff point of 2.75 g/dl provides the best sensitivity and specificity result.

Conclusions: Cord serum albumin level ≥3.4 g/dl are probably safe for early discharge whereas cord serum albumin level <3.4 g/dl will need a close follow-up to check for the development of jaundice.

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