Prediction of the Risk of Neonatal Hyperbilirubinaemia by Umbilical Cord Blood: A Prospective study.

ABSTRACT

Background: The incidence of jaundice in first week of life is very common affecting about 55% of term and 82% of preterm neonates. There should be specific guidelines for the early prediction of neonatal hyperbilirubinaemia by different available techniques. This will not only decrease the social, financial and medical burden but will also help in minimising the extent of brain damage. The aim of the present study is to confirm that umbilical cord blood bilirubin level is an important predictor of neonatal hyperbilirubinaemia. Besides this, the safe cut off value of bilirubin is also studied for early diagnosis of jaundice. Methods: It is an observational, prospective study in which the umbilical cord blood was collected for the estimation of serum bilirubin level and then again after 72 hours of life for estimation of serum total bilirubin. Statistical test using chi-square test of significance was applied and the predictive values (Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated using the conventional formulae. Results: Various maternal factors (age, parity and mode of delivery) and neonatal factors (sex, gestational age and birth weight) can influence the incidence of neonatal jaundice. It was an interesting finding that the neonates who had high umbilical cord bilirubin level, developed neonatal jaundice in the first week of life. The sensitivity and specificity of the test were highest in case of group 4 (96.5%) and (96.2%) respectively. The positive predictive value was highest in group 4 (42%) and negative predictive value was highest in group 3 (94%). Conclusion: The bilirubin estimation of umbilical cord blood can be an important indicator of neonatal jaundice and helps in planning the management of neonate.