Predictive value of umbilical cord bilirubin in occurrence of hyperbilirubinemia in neonates


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Babu K. R, Balu R, Praveen Kumar R and Nathiya

Objectives: Neonatal hyperbilirubinemia (NH) is a universal problem affecting nearly 60% of term and 80% of preterm neonates during first week of life. Early discharge of healthy term newborns is a common practice because of medical, social and economic constraints. In significant number (6.5%) of babies, NH is a cause for readmission. The present study was conducted to correlate the Cord Blood Bilirubin (CBB) level with subsequent NH.

Methods: Study was performed at the Department of Pediatrics in a Rajah Muthiah Medical College Hospital.150 full-term newborns during 1-year period, were prospectively enrolled. CBB was estimated. Serum Bilirubin estimation was done at 72 hours of age and later if required.

Results: Significant NH in our study is 1.3 %. Mean total bilirubin on third post natal day was 10.06 mg/dl. Using CBB level of ≥ 3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 99 %, positive predictive value of 66 % and negative predictive value of 100%.

Interpretation & Conclusion: A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤ 3 mg/dl ) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥ 3 mg/dl should be followed more frequently.

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