Neonatal hyperbilirubinemia prediction by cord blood and 24-hour serum bilirubin analysis

2020 ◽  
Vol 13 (3) ◽  
pp. 47-50
Author(s):  
Gurajala Chandra Sekhar ◽  
◽  
Radha Lavanya Kodali ◽  
Ramisetty Uma Mahesh ◽  
R Kedarnath ◽  
...  
Keyword(s):  
Cord Blood ◽  
Serum Bilirubin ◽  
Neonatal Hyperbilirubinemia

scholarly journals Study of Correlation of Cord Blood Bilirubin with Neonatal Hyperbilirubinemia

2016 ◽  
Vol 3 (1) ◽  
pp. 60 ◽  
Author(s):  
Nilesh Ahire ◽  
Ravindra Sonawane ◽  
Rajendra Gaikwad ◽  
Suhas Patil ◽  
Tushar Sonawane
Keyword(s):  
Cord Blood ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Early Discharge ◽  
Neonatal Hyperbilirubinemia ◽  
Research Centre ◽  
Preterm Neonates ◽  
College Hospital ◽  
Term Newborns

<strong>Introduction</strong>: Neonatal Hyperbilirubinemia (NH) is a universal problem affecting nearly 60% of term and 80% of preterm neonates during first week of life. Early discharge of healthy term newborns is a common practice because of medical, social and economic constraints. Insignificant number (6.5%) of babies, NH is a cause for readmission. The present study was conducted to correlate the Cord Blood Bilirubin (CBB) level with subsequent NH. <strong>Methods:</strong> Study was performed at the Department of Pediatrics in a Medical College Hospital and Research Centre. Intramurally delivered, 113 Healthy full-term newborns during 1-year period were prospectively enrolled. CBB was estimated. Serum Bilirubin estimation was done at 48 hours and 5 day of age and later if required. <strong>Results:</strong> Significant NH in our study is 3.5%. Mean total bilirubin on second postnatal day was 10.58 mg/dl and on fifth post natal day was 10.81 mg/dl. Using CBB level of ≥3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 98.17%, positive predictive value of 66.67% and negative predictive value of 100%. <strong>Conclusion:</strong> A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤3mg/dl) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥3mg/dl should be followed more frequently.

scholarly journals To study the correlation between various levels of cord blood albumin & serum bilirubin at 48 hrs of age in term healthy newborns

2021 ◽  
Vol 8 (3) ◽  
pp. 146-153
Author(s):  
Sunil Arya ◽  
◽  
Chetan Panwar ◽  
Jyoti Prajapati ◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Albumin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Care Hospital ◽  
Group I ◽  
Blood Albumin ◽  
Group Ii

Introduction: Neonatal Hyperbilirubinemia is the most common abnormal physical finding and themajor cause of neonatal morbidity during the early neonatal period. Early identification of infants atrisk might help in providing preventative therapy and follow-up. We aimed to assess whether arterialumbilical cord albumin level at birth predicts the development of neonatal hyperbilirubinemia in termnewborns at 48 hrs of life. Methods: This prospective observational cohort study was conducted ina tertiary care hospital over 1 year in 200 term healthy neonates. Cord blood albumin was estimatedat birth followed by serum bilirubin level on the 3rd postnatal day(48 hrs of age). Results: Total of200 neonates were divided into three groups based on cord blood albumin level of <2.8 g/dl(groupI), 2.8-3.4 g/dl(group II) and >3.4 g/dl(groupIII) with 32, 100 and 68 in three respective groups.19 newborns (59.4%) in group I,14 in group II, and 7 newborns (10.3%) in group III developedserum bilirubin levels above an intermediate high-risk zone in Bhutani nomogram at 48 hrs of age.newborn with low cord albumin (<2.8g/dl) were significantly associated with higher bilirubin levelsat 48 hrs of age. Conclusion: Neonates with cord blood albumin <2.8 gm/dl had a significantassociation of the development of hyperbilirubinemia at or above intermediate high-risk zoneaccording to Bhutani nomogram at 48 hrs of life.

scholarly journals Utility of cord blood bilirubin as a predictors of significant neonatal Hyperbilirubinemia in healthy term neonate

2019 ◽  
Vol 6 (5) ◽  
pp. 2058
Author(s):  
Rajkumar M. Meshram ◽  
Saira Merchant ◽  
Swapnil D. Bhongade ◽  
Sartajbegam N. Pathan
Keyword(s):  
Positive Predictive Value ◽  
Cord Blood ◽  
Negative Predictive Value ◽  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Mode Of Delivery ◽  
Neonatal Hyperbilirubinemia ◽  
Term Neonates

Background: Clinical jaundice is evident in more than two-third neonates in their early neonatal life. Early identification of neonates at risk might allow early intervention and prevent complication. Objective of the study was to assess the cord blood bilirubin level as a tool to screen the risk of development of subsequent significant neonatal hyperbilirubinemia in term neonates.Methods: A prospective observational study was conducted over a period of 2 years on 1040 healthy term neonates. Demographic profile, relevant maternal and neonatal information were recorded. Measurement of cord blood bilirubin, blood group/Rh typing and serum bilirubin at the end of 24 & 72 hours was done to predict significant hyperbilirubinemia.Results: Incidence of significant hyperbilirubinemia was 11.53%. Gender, gestational age, mode of delivery and birth weight had no correlation with development of significant jaundice. 800 (76.93%) neonates had cord blood bilirubin level ≤3.0mg/dl and 240 (23.07%) neonate had cord blood bilirubin level >3.0mg/dl. Out of 240 (23.07%) neonates with higher cord bilirubin (>3.0 mg/dl), 108 (45%) had significant hyperbilirubinemia at the end of 24 hours with sensitivity 90.00%, specificity 85.65%, positive predictive value 45.00% and negative predictive value 98.50% while 110 (45.83%) neonates were observed with serum bilirubin >17mg/dl at the end of 72 hours with cord blood bilirubin >3mg/dl with sensitivity 91.67%, specificity 84.52% positive predictive value 45.83% and negative predictive value-98.61% and this difference was statistically significant.Conclusions: Neonates with cord blood bilirubin level ≤3mg/dl can be safely discharged early whereas neonates with bilirubin >3mg/dl will need close follow up to check for development of subsequent significant jaundice. Hence cord blood bilirubin levels help to determine and predict the possibility of significant jaundice among healthy term neonates.

scholarly journals Prediction of neonatal hyperbilirubinemia by cord blood analysis to diagnose subsequent hyperbilirubinemia

2019 ◽  
Vol 6 (4) ◽  
pp. 1658
Author(s):  
S. K. Mahammad Rafi ◽  
Vani Gandikota ◽  
Gangadhar B. Belavadi
Keyword(s):  
Cord Blood ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Blood Analysis ◽  
Neonatal Hyperbilirubinemia ◽  
Cord Blood Sample ◽  
Female Ratio ◽  
Term Neonates ◽  
Male Female Ratio ◽  
The Difference

Background: the study was aimed to determine the predictive value of cord bilirubin and 24th hour serum bilirubin levels in identifying newborn babies at risk of developing significant hyperbilirubinemia.Methods: A total 300 term neonates with a mean birth weight of 2.58±0.23 kg ranging from 1.92 kg-4.1kg were included in this study. Under strict aseptic precautions cord blood sample were collected from all newborns for analysis of serum bilirubin levels, and haemoglobin levels.Results: The incidence of significant hyperbilirubinemia in this study was 14%. Among jaundiced newborns sex ratio M/F:1.6:1(male female ratio 1.1:1). Mean Cord bilirubin levels in babies who subsequently developed hyperbilirubinemia was 2.798±0.5559 mg/dl and in others were 1.511±0.3260 mg/dl and the difference was statistically significant. There was a statistically significant correlation between cord bilirubin and neonatal jaundice. Cord bilirubin ≥2 mg/dl had good predictive value in identifying newborns who are likely to develop significant hyperbilirubinemia later.Conclusions: Babies with cord blood bilirubin ≥2 mg/dl can be followed up in the hospital for 5 days, the time of peak neonatal hyperbilirubinemia to prevent the babies discharged early and later readmission for neonatal hyperbilirubinemia.

scholarly journals Cord blood bilirubin, albumin, and bilirubin /albumin ratio for predicting subsequent neonatal hyperbilirubinemia

2019 ◽  
Vol 59 (5) ◽  
pp. 244-51
Author(s):  
Jehangir Allam Bhat ◽  
Sajad Ahmad Sheikh ◽  
Roshan Ara
Keyword(s):  
Cord Blood ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Early Discharge ◽  
Serum Bilirubin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Albumin Ratio ◽  
Level Measurement ◽  
Physiological Values ◽  
Group B

Background Early discharge of healthy term newborns after delivery has become a common practice, because of medical and social reasons, as well as economic constraints. Thus, the recognition, follow-up, and early treatment of jaundice has become more difficult as a result of early discharge from the hospital. Since the dreaded complication of neonatal hyperbilirubinemia is kernicterus, an investigation which can predict the future onset of neonatal pathological jaundice is needed. Objective To investigate the predictability of neonatal hyperbilirubinemia by using cord blood bilirubin, albumin and bilirubin/albumin ratio. Methods This study was conducted on 300 healthy newborns. Umbilical cord blood was used to measure albumin and bilirubin. All infants were regularly followed up to 5th day of life. Neonates were divided into two groups: group A was consisted of neonates who developed jaundice which was in physiological range, while group B was consisted of neonates who developed neonatal hyperbilirubinemia (requiring phototherapy or other modality of treatment). Babies suspected to have bilirubin level which cross physiological limit on any day after birth were subjected to serum bilirubin measurement. Infants whose serum bilirubin level measurement revealed bilirubin levels crossing physiological values were sent to nursery for phototherapy. Results The incidence of neonatal hyperbilirubinemia was 11%. Statistically significant correlations between cord blood bilirubin, albumin, and bilirubin/albumin ratio to the development of neonatal hyperbilirubinemia were observed. On ROC analysis, cut-off points to predict significant hyperbilirubinemia in newborn were cord blood bilirubin >3 mg/dL (sensitivity 60.61%, specificity 97.63%), albumin <2.4 mg/dL (sensitivity 78.79%, specificity 98.13%), cord blood bilirubin/albumin ratio >0.98  (sensitivity 78.79%, specificity 95.51%). Conclusion Cord blood total bilirubin, albumin. and bilirubin/albumin ratio are excellent parameters to predict the occurrence of neonatal hyperbilirubinemia. However, cord blood albumin is better compared to cord blood bilirubin and bilirubin/albumin ratio.

scholarly journals Umbilical cord albumin and serum bilirubin as predictive factors for hyperbilirubinemia in term neonates

2020 ◽  
Vol 7 (2) ◽  
pp. 267
Author(s):  
Manu Shekhar ◽  
Vinod Kumar ◽  
Santosh Bhalke ◽  
Atul Goel
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Venous Blood ◽  
Predictive Marker ◽  
Albumin Level ◽  
Neonatal Hyperbilirubinemia ◽  
Blood Albumin ◽  
One Year

Background: Hyperbilirubinemia is one of the common causes of neonatal admission. As clinical evaluation may cause a delay in identification and subsequent initiation of medical therapy, there is a need for the sensitive and inexpensive predictive marker for hyperbilirubinemia in neonates. Measurement of cord albumin and its correlation with the serum bilirubin is one of the noninvasive predictive markers for Hyperbilirubinemia. The present study carried out to know the significance of umbilical cord albumin level as a predictor of neonatal hyperbilirubinemia.Methods: It is a hospital-based prospective cohort study, total 100 healthy term new-borns admitted in the Neonatal Intensive Care Unit, were included in the study as per study protocol over a period of one year. The blood sample was collected from umbilical cord blood for the analysis of bilirubin and albumin, and post 72 hours of life venous blood obtained for estimation of serum bilirubin and albumin along with direct and indirect Coombs test.Results: In this study most of the patients were in the gestational age of 37-38 weeks (71%) followed by 38-40 weeks (27%) and only 1% are >40 weeks. A positive correlation was observed between cord blood bilirubin, serum bilirubin, serum albumin, and cord blood albumin levels. Cord blood albumin was a better marker for neonatal hyperbilirubinemia with a sensitivity of 83%, and a specificity of 48%; as compared to cord blood bilirubin with a sensitivity and specificity of 73% and 39% respectively.Conclusions: From this study, cord blood albumin level was demonstrated as a good predictive marker for neonatal hyperbilirubinemia with a sensitivity of 83.1%. and specificity 48.8%. Hence, cord blood albumin may be used as a non-invasive predictor for neonatal hyperbilirubinemia.

Neonatal Hyperbilirubinemia and Physical and Cognitive Performance at 17 Years of Age

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 828-833
Author(s):  
Daniel S. Seidman ◽  
Ido Paz ◽  
David K. Stevenson ◽  
Arie Laor ◽  
Yehuda L. Danon ◽  
...  
Keyword(s):  
Test Scores ◽  
Serum Bilirubin ◽  
School Achievement ◽  
Ethnic Origin ◽  
Full Term ◽  
Neonatal Hyperbilirubinemia ◽  
Intelligence Test ◽  
Coombs Test ◽  
Intelligence Test Scores ◽  
The Military

To estimate the effect of neonatal hyperbilirubinemia on long-term cognitive ability in full-term newborns with a negative Coombs test, we performed a 17-year historical prospective study of 1948 subjects. Intelligence tests and medical examinations performed at the military draft board were stratified according to serum bilirubin concentration. A logistic regression analysis was used to adjust for the confounding effects of gestational age, birth weight, Apgar score, ethnic origin, socioeconomic class, paternal education, birth order, and the administration of phototherapy and exchange transfusion. No direct linear association was shown between neonatal bilirubin levels and intelligence test scores or school achievement at 17 years of age. However, the risk for low intelligence test scores (IQ score &lt;85) was found to be significantly higher (P = .014) among full-term male subjects with serum bilirubin levels above 342 µmol/L (20 mg/dL) (odds ratio, 2.96; 95% confidence interval, 1.29-6.79). This association was not observed among female subjects. We conclude that severe neonatal hyperbilirubinemia, among full-term male newborns with a negative Coombs test, could be associated with lower IQ scores at 17 years of age.

scholarly journals Correlation between Neonatal Hyperbilirubinemia and Serum Magnesium and Copper Levels in Dhaka City

2020 ◽  
pp. 125-131
Author(s):  
Mohammad Anwar Hossain ◽  
Md. Ekramul Islam ◽  
Ashik Mosaddik ◽  
Md. Saiful Islam ◽  
Md. Nazmul Huda ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Serum Magnesium ◽  
Colorimetric Method ◽  
Newborn Infants ◽  
Sulfanilic Acid ◽  
Neonatal Hyperbilirubinemia ◽  
P Value ◽  
Control Groups ◽  
Automated Method ◽  
Acid Reaction

Background: Neonatal hyperbilirubinemia is a condition when a newborn has an excessive amount of bilirubin in the blood and is one of the most prevalent problems in   neonates. Many studies reported that copper and magnesium play an important role in the pathogenesis and development of neonatal hyperbilirubinemia. Objectives: The aim of this study is to find out the correlation between the level of magnesium and copper with hyperbilirubinemia. Methodology: Serum bilirubin was assayed with colorimetric method by the use of diazotized sulfanilic acid reaction. A photometric automated method was used to determine the levels of magnesium and copper in the serum of neonates in both controls group (162) and cases group (220). Results: In the present study a significantly higher levels of Mg was found in hyperbilirubinemia of newborn infants when compared with control groups (23.67 ±2.33 mg/L versus 19.74 ±2.18 mg/L respectively and p value <0.001 which was significant) and correlation between hyperbilirubinemia and magnesium also significant (p value <0.001). Copper levels was significantly higher in hyperbilirubinemia of newborn infants (0.74 ±0.08 mg/L) compared with control groups (0.41 ±0.12 mg/L), where p value was <0.001, which was significant and correlation between hyperbilirubinemia and copper also significant (p value <0.001). Conclusion: It can be concluded that current study showed the concentrations of magnesium and copper levels were found to be significantly greater than control groups and may have a correlation with neonatal jaundice.

scholarly journals Intestinal NCoR1, a regulator of epithelial cell maturation, controls neonatal hyperbilirubinemia

2017 ◽  
Vol 114 (8) ◽  
pp. E1432-E1440 ◽  
Author(s):  
Shujuan Chen ◽  
Wenqi Lu ◽  
Mei-Fei Yueh ◽  
Eva Rettenmeier ◽  
Miao Liu ◽  
...  
Keyword(s):  
Acid Metabolism ◽  
Serum Bilirubin ◽  
Neonatal Hyperbilirubinemia ◽  
Intestinal Epithelial ◽  
Targeted Deletion ◽  
Bilirubin Encephalopathy ◽  
Intestinal Maturation ◽  
Immunohistochemistry Analysis ◽  
Developmental Maturation ◽  
Target Activation

Severe neonatal hyperbilirubinemia (SNH) and the onset of bilirubin encephalopathy and kernicterus result in part from delayed expression of UDP-glucuronosyltransferase 1A1 (UGT1A1) and the inability to metabolize bilirubin. Although there is a good understanding of the early events after birth that lead to the rapid increase in serum bilirubin, the events that control delayed expression of UGT1A1 during development remain a mystery. HumanizedUGT1(hUGT1) mice develop SNH spontaneously, which is linked to repression of both liver and intestinal UGT1A1. In this study, we report that deletion of intestinal nuclear receptor corepressor 1 (NCoR1) completely diminishes hyperbilirubinemia inhUGT1neonates because of intestinalUGT1A1gene derepression. Transcriptomic studies and immunohistochemistry analysis demonstrate that NCoR1 plays a major role in repressing developmental maturation of the intestines. Derepression is marked by accelerated metabolic and oxidative phosphorylation, drug metabolism, fatty acid metabolism, and intestinal maturation, events that are controlled predominantly by H3K27 acetylation. The control of NCoR1 function and derepression is linked to IKKβ function, as validated inhUGT1mice with targeted deletion of intestinal IKKβ. Physiological events during neonatal development that target activation of an IKKβ/NCoR1 loop in intestinal epithelial cells lead to derepression of genes involved in intestinal maturation and bilirubin detoxification. These findings provide a mechanism of NCoR1 in intestinal homeostasis during development and provide a key link to those events that control developmental repression of UGT1A1 and hyperbilirubinemia.

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