Cord Blood Bilirubin as an Early Marker of Hyperbilirubinemia in Term and Late Preterm Newborns at 48 Hours of Life: A Prospective Cohort Study
Introduction: Jaundice is a common clinical condition present during the neonatal period, which can be either physiological or pathological. Early discharge of newborns is a common practice in our country due to medico-social and economic reasons, making post-discharge follow-up of infants chal...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18324/64205_CE[Ra1]_F(SHU)_QC(KK_SHU)_RDW(NC)_PF1(AKA_KM)_PFA(AKA_KM)_PN(KM).pdf |
| Summary: | Introduction: Jaundice is a common clinical condition
present during the neonatal period, which can be either
physiological or pathological. Early discharge of newborns
is a common practice in our country due to medico-social
and economic reasons, making post-discharge follow-up of
infants challenging compared to developed countries.
Aim: To determine the correlation between cord blood bilirubin
levels and the occurrence of hyperbilirubinemia at 48 hours of
life in newborns with a gestational age of ≥35 weeks.
Materials and Methods: This cohort study was conducted in
the Department of Pediatrics at Dr SMCSI Medical College,
Karakonam, Trivandrum, Kerala, India, over a one-year period
from June 2017 to June 2018. The exposure variables included
the mother’s blood group, baby's blood group, mode of
delivery, gestational age, gender, and weight of the baby. The
outcome variables included cord blood and 48-hour serum total
and direct bilirubin levels. The data was coded and entered
into Microsoft Excel and analysed using Statistical Package
for Social Science (SPSS) version 16.0. Descriptive measures
were calculated, and the correlation between cord and 48-
hour bilirubin levels was assessed using Pearson's correlation
coefficient formula. Other statistical tests applied were chisquare test and independent t-test.
Results: Total subjects of 500 (243 female and 257 were
males) participants were included in the study.Among the 21
babies who underwent phototherapy, 11 were female and 10
were male, and 15 were full term and six were late preterm for
their gestational age . Of the 21 babies needing phototherapy,
15 were delivered by normal vaginal delivery, and six were
delivered by LSCS. Correlation between cord blood bilirubin
and serum bilirubin at 48hr is 0.477 with a p-value <0.001;
which indicates mild correlation between the cord blood Total
Bilirubin (TB)and serum TB. A cord TB value of 1.45 mg/dL
had a sensitivity of 95.2% and specificity of 32.5%. A value
of 1.55 mg/dL had a sensitivity of 90.5% and specificity of
40.9%. A cord TB value of 1.65 mg/dL had a sensitivity of
66.7% and specificity of 53.9%. These findings suggest that
cord bilirubin levels can be used to predict which babies
require further evaluation and treatment.
Conclusions: Cord blood serum bilirubin can serve as a useful
screening test for predicting neonatal hyperbilirubinemia and
ensuring safe post-natal hospital discharge. |
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| ISSN: | 2249-782X 0973-709X |