Cord Blood And 1st Day Bilirubin Level As A Predictor Of 3rd Day Hyperbilirubinemia In Newborns With Birth Weight >2000g

Cord Blood And 1st Day Bilirubin Level As A Predictor Of 3rd Day Hyperbilirubinemia

Abstract

Aims: To evaluate whether bilirubin levels in cord blood and 1st day could predict neonatal hyperbilirubinemia to their third day of life. Settings and Design: Prospective non randomized study in tertiary care hospital and medical college. Methods and Material: In 100 healthy newborns with birth weight > 2000g, cord blood bilirubin, serum bilirubin at days 1 (20 to 25 h) and 3 (65 to 75 h) of life was obtained. Newborns with signs of ecchymosis, cephalhaematoma, septicemia, G6PD deficiency and APGAR <7 at 1min were excluded from the study. Total bilirubin ≥ 14 mg/dl measured on 3rd day was considered as significant hyperbilirubinemia. Cord and 1st day bilirubin was used as a predictor of 3rd day hyperbilirubinemia (3DHB). Statistical analysis: T-test, chi-square, Receiver Operating Characteristics (ROC) curve. Results: 22 newborns developed 3rd day hyperbilirubinemia (≥ 14 mg/dl). Cord blood bilirubin level of ≥1.75mg/dl has sensitivity 81%, specificity 77%, positive predictive value 50% and negative predictive value of 90% in predicting the risk of 3DHB. 1st day (20-25h) bilirubin level of ≥4.1 mg/dl has a sensitivity 62 %, specificity 93 %, positive predictive value 77 % and the negative predictive value of 87 % in predicting the risk of 3DHB. There was significant association between 3DHB with oxytocin induction of labour (p=0.0185) and mean cord blood bilirubin (p=0.0001). Conclusions: Cord blood bilirubin level of ≥1.75mg/dl (moderately positive correlation-0.53) or 1st day level of ≥4.1 mg/dl (moderately positive correlation-0.65) can predict the development of 3rd day hyperbilirubinemia (S. Bilirubin ≥14 mg/dl). Oxytocin induction of labour has significant correlation with 3rd day hyperbilirubinemia. [Parekh N Natl J Integr Res Med, 2019; 10(5):12-15]