Correlation of cord blood bilirubin and neonatal hyperbilirubinemia in healthy newborns

Background: Jaundice is one of the commonest problems that can occur in a newborn. During the first week of life all new-borns have increased bilirubin levels by adult standards, with approximately 60% of term babies 1 and 85% of preterm babies having visible jaundice. This physiological rise in bilirubin causes indirect hyperbilirubinemia after 24 hours of birth, rises progressively with age and resolves gradually with no intervention in majority of cases. A small percentage may however require phototherapy or exchange transfusion when the bilirubin levels exceed the normal range.Methods: This study was performed at the Neonatal Intensive Care Unit, Department of Pediatrics of Rohilkhand Medical College and Hospital, Bareilly. All the healthy newborns <37weeks-41weeks>, delivered at this hospital fulfilling the inclusion and exclusion criteria were enrolled in the study during One year from January 2014 to January2015. Inclusion criteria was healthy new-borns (37weeks-41weeks) delivered at Rohilkhand Medical College and Hospital and exclusion criteria was Setting of ABO incompatibility, ABO incompatibility, Rhesus blood factor incompatibility. The present study was conducted on 100 term healthy neonates delivered at tertiary care hospital. Serum bilirubin level was estimated at birth (cord blood) and at 3rd day of life. The main outcome measured was significant hyperbilirubinemia requiring treatment (phototherapy/exchange transfusion). Serum bilirubin was estimated clinically as indicated and on day 3 of life.Results: The area under curve was observed to be 0.75, i.e., the predictive accuracy of the criteria is 75% which implies a fair predictive value of the criteria. Receiver operator curve analysis revealed that a cut-off of 1.875 was 61.3% sensitive and 76.8% specific.Conclusions: Cord blood bilirubin level of more >1.87mg/dl can reliably predict neonatal hyperbilirubinemia in healthy term neonates.