Cord Blood Bilirubin as a Predictive Marker of Neonatal Hyperbilirubinemia in ABO and Rh Incompatible Babies: A Prospective study

INTRODUCTION: Hyperbilirubinemia is the most common clinical problem in the neonatal period requiring evaluation and treatment. It is also a common cause of readmission to the hospital. Although it is mostly due to physiological process, few newborns develop potentially high bilirubin value posing serious damage to the brain. Over the past few years, routine hospital stay for mothers and newborns has been reduced. This practice of early hospital discharge has led to increased rate of readmission to hospitals due to the conditions attributed by jaundice, which usually may not be evident in first 2-3 days of life. Thus early prediction of newborns at risk of NH is a good option. AIMS AND OBJECTIVE: Of the study is to predict the usefulness of cord blood bilirubin in identifying subsequent hyperbilirubinemia in ABO and Rh incompatible babies requiring therapeutic intervention so that early postpartum discharge of both mother and those newborns can be planned. METHODOLOGY: prospective study conducted over a period of 1 year. 100 healthy term neonates were selected based on inclusion and exclusion criteria. Cord blood was collected at birth and sent for serum total bilirubin analysis. Babies were examined daily and looked for the evidence of jaundice. Serum blood was drawn at 72 hours of life for all babies. Blood for evaluation of total bilirubin was also drawn at less than 72 hours of life from babies who showed clinical evidence of jaundice. RESULTS AND CONCLUSION: the UCSB level >2.3mg/dl was considered to predict the postnatal significant hyperbilirubinemia with sensitivity and specificity of 95.35% and 100% respectively suggesting that these high risk babies should be monitored very closely and frequently and warrants early discharge.