Abstract

UMBILICAL CORD BILIRUBIN LEVEL AS A PREDICTOR OF SUBSEQUENT NEONATAL HYPERBILIRUBINAEMIA IN TERM HEALTHY NEWBORNS

Author(s): Chandrashekar Gopal Shettigar1, Sanchita Shettigar2, Swathi Sanjee3

BACKGROUND
Hospital readmission due to neonatal hyperbilirubinaemia is a cause for concern among parents as well as clinicians. Early discharge carries the risk of delayed recognition of hyperbilirubinaemia and the possibility of bilirubin-induced brain damage.
The aim of the study is to correlate the umbilical cord bilirubin level as a predictor of subsequent neonatal hyperbilirubinaemia in term healthy newborns.
MATERIALS AND METHODS
This was a prospective study conducted at tertiary care teaching hospital for the period of one year. A total of 192 healthy term newborns were included in the study and subjected to cord blood analysis for bilirubin. Further at 72 hours of life, blood for serum bilirubin was again collected and the two values were compared.
RESULTS
Out of 192 neonates studied, 29 (15.1%) newborns were developed significant jaundice (serum bilirubin ≥17 mg/dL) at 72 hours of life. Term healthy newborns having cord bilirubin value <2 mg/dL had only 2.8% risk of developing significant hyperbilirubinaemia when compared to newborns with cord bilirubin >2.5 mg/dL who had 68.2% risk of developing hyperbilirubinaemia, which was statistically significant (p<0.005). The cord bilirubin level of >2.5 mg/dL had the higher specificity (95.7%), negative predictive value (91.8%) and fairly better positive predictive value (68.2%) in predicting significant hyperbilirubinaemia of ≥17 mg/dL at 72 hours of life.
CONCLUSION
Estimating cord blood bilirubin is helpful in identifying neonates who may develop significant hyperbilirubinaemia warranting therapeutic intervention. Increase in cord bilirubin level associated with increase in chances for subsequent hyperbilirubinaemia.