A study to determine the level of cord blood albumin in predicting neonatal jaundice
DOI:
https://doi.org/10.18203/2349-3291.ijcp20201040Keywords:
Bilirubin, Albumin, Jaundice, Neonate, PredictorAbstract
Background: Most unconjugated bilirubin formed by the fetus is cleared by the placenta into the maternal circulation. Albumin constitutes 70 - 75% of Plasma oncotic pressure. Another important function of albumin is its antioxidant property. Bilirubin binds to albumin in an equimolar ratio. Free bilirubin is anticipated when the molar bilirubin- to- albumin (B: A) ratio is >0.8 Objective of the study was to predict the proportion of newborn requiring intervention for NH (phototherapy or exchange transfusion) based on cord serum albumin level at birth.
Methods: The present prospective study was conducted at Navodaya Medical College, Raichur from October 2018 to November 2019. A total of 180 babies which were born during the study period were included in the study. INCLUSION CRITERIA• Term babies both genders• Mode of delivery (normal and C-section)• Birth weight ≥2.5kg.• APGAR ≥7/10 at 1 min. Cord Serum Albumin level was estimated at birth. Total Serum Bilirubin (TSB) estimation was done at 72-96 hours of age. All the babies were followed up daily for first 4 postnatal days and babies were daily assessed for NH and its severity.
Results: In our study nearly 54.4% of them had Cord Serum Albumin levels of less than 2.8 gm/dl, 27.3% of them had albumin levels of 2.9 to 3.3 gm/dl, 18.3% of them had Serum Albumin of 3.4 gm/dl. Out of 180 study subjects, 13.9% of them required phototherapy to treat neonatal hyper bilirubinemia and 2.8% of the study subjects required exchange transfusion.
Conclusions: From the present study, cord serum albumin level of ≤2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So, this ≤2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia.
References
Cloharty JP, Stork AR, Eichenwald EC, Hansen AR. Manual of neonatal care. Chapter 26, Neonatal Hyperbilirubinemia. 7th edn. Philadelphia: Lippincott Willams and Wilkins; 2012:304-339.
Guruprasad G. Bilirubin Metabolism- what we should know? J Neonatol. 2001;1:4-7.
Madan A, James RM, Stevenson DK. Neonatal Hyperbilirubinemia. In: Taeusch HW, Ballard RA, Gleason CA. Avery's diseases of the new born. 8th Ed. Philadelphia: Elsevier Saunders; 2004:1226-1256.
Kliegman RM, Behrman RE, Stanton BF, Schor.NF. Jaundice and Hyperbilirubinemia in the Newborn. Nelson textbook of Pediatrics. 19th ed. Philadelphia: Saunders; 2012:603-608.
Whitington PF, Alonso EM. Disorder of Bilirubin Metabolism. In: Nathan DG, Orkin SH, Ginsberg D, Thomas LA. Hematology of Infancy and Childhood. 6th edn. Philadelphia: Saunders Company; 2003:86-120.
Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatr. 1998 Jun 1;101(6):995-8.
Taksande A, Vilhekar K, Jain M, Zade P, Atkari S, Verkey S. Prediction of the development of neonatal hyperbilirubinemia by increased umbilical cord blood bilirubin. Ind Medica. 2005;9(1):5-9.
Rostami N, Mehrabi Y. Identifying the newborns at risk for developing significant hyperbilirubinemia by measuring cord bilirubin levels. J Arab Neonatal Forum. 2005;2:81-5.
Randew S, Grower N. Predicting neonatal hyperbilirubinemia using first day serum bilirubin levels. Indian J Pediatr. 2010;77:147-50.
Alpay F, Sarici SÜ, Tosuncuk HD, Serdar MA, Inanç N, Gökçay E. The value of first-day bilirubin measurement in predicting the development of significant hyperbilirubinemia in healthy term newborns. Pediatr. 2000 Aug 1;106(2):e16.
Palmer DC, Drew JH. Jaundice a 10-year review of 41000 live born infants. Aust Pediatr. 1983;19(2):86-9.
Agarwal R, Deorari AK. Unconjucated Hyperbilirubinemia in Newborn. Indian Pediatr. 2002;17(39):30-42.
Sahu S, Abraham R, John J, Mathew MA, Res M. Cord blood albumin as a predictor of neonatal jaundice. Int J Biol Med Res. 2011;2(1):436-8.
Trivedi DJ. Cord serum bilirubin and albumin in neonatal hyperbilirubinemia. Int J Int Sci Inn Tech Sec A. 2013;2(2):39-42.
