May Ahmed Khairy1, Walaa Alsharany Abuelhamd2, Ismail Mohamed Elhawary3, Ahmed Said Mahmoud Nabayel4. 1. Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: maykhairy@yahoo.com. 2. Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: walaa_alsharany@hotmail.com. 3. Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: Elhawary_20@yahoo.com. 4. Department of Pediatrics, Ministry of Health, Cairo, Egypt. Electronic address: DrAhmedSaid87@gmail.com.
Abstract
BACKGROUND: Reliable predictive markers enabling physicians to identify which newborns will develop significant hyperbilirubinemia have become mandatory for prevention of severe hyperbilirunemia. We aimed at determining the critical cord serum bilirubin and albumin levels and bilirubin/albumin ratio early as reliable markers. STUDY DESIGN: This prospective study included 175 full-term neonates. Measurement of cord bilirubin, albumin and bilirubin/albumin ratio was done to predict significant hyperbilirubinemia in healthy term newborns based on serum bilirubin measurements made within 5 days of life. RESULTS: Most cases that developed significant neonatal hyperbilirubinemia (67.9%) had cord albumin level ≤ 2.8 gm/dl. Cord Bilirubin/albumin ratio cut off value > 0.61 had a good predictive value with a sensitivity of 100% and specificity of 88.4%, and cord serum albumin cut off value ≤ 3.0 mg/dl also had a good predictive value with a sensitivity of 85.7% and specificity of 67.3%. ROC curve analysis of cord total bilirubin demonstrated that a cut off value of ≥1.84 mg/dl had a good predictive value with a sensitivity of 100.0% and specificity of 87.1%. CONCLUSION: Cord bilirubin/albumin ratio, serum bilirubin and albumin could be early predictors for neonatal hyperbilirubinemia.
BACKGROUND: Reliable predictive markers enabling physicians to identify which newborns will develop significant hyperbilirubinemia have become mandatory for prevention of severe hyperbilirunemia. We aimed at determining the critical cord serum bilirubin and albumin levels and bilirubin/albumin ratio early as reliable markers. STUDY DESIGN: This prospective study included 175 full-term neonates. Measurement of cord bilirubin, albumin and bilirubin/albumin ratio was done to predict significant hyperbilirubinemia in healthy term newborns based on serum bilirubin measurements made within 5 days of life. RESULTS: Most cases that developed significant neonatal hyperbilirubinemia (67.9%) had cord albumin level ≤ 2.8 gm/dl. Cord Bilirubin/albumin ratio cut off value > 0.61 had a good predictive value with a sensitivity of 100% and specificity of 88.4%, and cord serum albumin cut off value ≤ 3.0 mg/dl also had a good predictive value with a sensitivity of 85.7% and specificity of 67.3%. ROC curve analysis of cord total bilirubin demonstrated that a cut off value of ≥1.84 mg/dl had a good predictive value with a sensitivity of 100.0% and specificity of 87.1%. CONCLUSION: Cord bilirubin/albumin ratio, serum bilirubin and albumin could be early predictors for neonatal hyperbilirubinemia.