Study of Cord Blood Bilirubin and Albumin Levels as Predictors of Subsequent Significant Hyperbilirubinemia in Healthy Newborns

Neonatal hyperbilirubinemia needs appropriate and timely treatment no matter whether it is arising from physiological or pathological causes.1 Adults appear jaundiced when the total serum bilirubin level exceeds 2.0 mg/dl while newborns appear jaundiced when it is >7mg/dl.2 Clinical jaundice is seen in 60- 70% of term and in about 80% of preterm newborns. Serum bilirubin value over 15 mg/dl is found in 3% of normal term newborns. 2,3 Late preterm babies are at higher risk for severe hyperbilirubinemia than term infants since there is decrease in hepatic bilirubin conjugation capacity and decrease in activity of the uridine diphosphate glucuronyltransferase (UDPGT) enzyme, as the gestational age (GA) decreases. 4,5,6 American Academic of Paediatrics (AAP) recommends that newborn discharged within 48 hours should have a follow-up visit after 48 to 72 hours for any significant jaundice and other problems.7 There are some reliable strategies for prediction of jaundice in neonates, soon after delivery. These are universal follow-up within 1–2 days of early discharge, cord blood albumin levels8, cord blood bilirubin concentration at birth 9, first day serum bilirubin measurement 10, routine pre-discharge serum bilirubin 11, transcutaneous bilirubin measurement 12, and the universal clinical assessment of risk factors of developing jaundice 13

Author(s): Swapnil B Thakkar

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