JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES

Abstract

Background: Neonatal hyperbilirubinemia is the commonest abnormal physical finding during the first week of life and its early detection is essential for prevention of bilirubin encephalopathy. Early discharge of healthy term neonates is a com-mon practice due to various reasons. The commonest cause for readmission of a normal neonate during early neonatal peri-od is neonatal hyperbilirubinemia. Readmission causes considerable stress to the family members. Aims: To assess whether cord blood albumin level could be used to predict the occurrence of significant jaundice requiring intervention. Settings and Design: It is a prospective study undertaken in postnatal wards of a teaching hospital. Material and Methods: Cord blood albumin was estimated in 130 healthy term neonates and they were divided into 3 groups based on cord blood albumin levels as follows: Group 1 with albumin levels <2.8g/dl; Group 2 with albumin levels between 2.8 and 3.3 g/dl and Group 3 with albumin levels of > 3.3g/dl. All the enrolled neonates were followed up for 72 hours and observed for clinical jaundice based on yellowish discoloration of skin. Neonates with evidence of clinical jaun-dice were subjected to total serum bilirubin estimation and hour specific values were plotted on Bhutani’s charts. Results: Clinical jaundice was present in 100 neonates for whom serum bilirubin estimation was done. There was a signifi-cant negative correlation between cord blood albumin levels and total serum bilirubin. Out of 100 neonates with clinical jaundice, 19 received phototherapy for significant hyperbilirubinemia. While all neonates in Group 1 received phototherapy none in Group 3 received intervention which was highly significant (p value <0.0001). Conclusion: Cord blood albumin estimation helps in predicting the possibility of hyperbilirubinemia in healthy term neo-nates.

Key words: Cord blood albumin, Neonatal hyperbilirubinemia, Phototherapy