CAN CORD BLOOD BILIRUBIN BE USED AS PREDICTIVE MARKER FOR HYPERBILIRUBINEMIA IN NEWBORNS? A PROSPECTIVE STUDY

V. N. Nandanwar and N. S. Raghupathy*

ABSTRACT

Background: The most common causes of admission to hospital in the neonatal period is due to hyperbilirubinemia. Hyperbilirubinemia is a major contributor of morbidity in neonates. Prevention of serious complications is the main aim. Early discharge from the hospital which is widely seen now days might cause delay in recognition of hyperbilirubinemia. A remarkable biomarker identifier could be of real advantage and advancement. Methods: This study was undertaken to study weather cord blood bilirubin can be used as a predictor for hyperbilirubinemia. The study was taken up in the department of pediatrics of a tertiary teaching hospital. A total of 100 babies were taken for the study during the whole study period. The babies were examined and a detailed clinical examination was done at the time of birth and documented along with maternal history. The cord blood at the time of delivery and 48 hour serum blood was collected and sent to the lab for bilirubin level estimation. Results: The study consisted of 53 females and 47 males. Out of the 100 subjects 73 were caesarean and 27 were normal vaginal deliveries. With regard to term of gestation 72 babies were early term, 23 full-term and 5 late term. The mean cord bilirubin was 2.44mg/dl and the mean 48 hour serum bilirubin level was 13.12mg/dl. The incidence of hyperbilirubinemia in this study was 25%. The sensitivity was 35%, specificity was 75%, positive predictive value was 58.33%, negative predictive value 53.57%, false negative was 65% and false positive was 25%. Test for correlation was done between cord bilirubin and 48 hour serum bilirubin. There was moderate level (r > 0.3) of correlation which was highly significant (p < 0.001). Conclusion: This study concluded cord bilirubin can be used as a predictor for hyperbilirubinemia.

Keywords: Hyperbilirubinemia, cord blood and 48 hour serum blood.