OBJECTIVE:To correlate Total Serum Bilirubin (TSB) values to the clinical course of hyperbilirubinemia in newborns as this can be an indirect method of quality assurance in the laboratory. METHODS: An observational study of bilirubin values from 100 randomly selected case records of newborn jaundice for a period of 6 months. TSB values were determined by diazo reaction on venous blood samples on a semi auto analyzer. MS excel sheet used for statistical analysis. RESULTS: Clinical course of hyperbilirubinemia in all subjects correlated well to the reported TSB values in first to last zones corresponding to <6mg/dL and >15mg/dL on 3rd day to 5th day of age. Zones 3, 4 and 5 varied from 7th day of birth, as phototherapy and recovery altered visual assessment of jaundice. One patient was expired with kernicterus had very high TSB value. The median bilirubin values trend downfall which correlated clinically to recovery from jaundice and 33% rapid decline in TSB also indicated the intervention by phototherapy. CONCLUSIONS: Bilirubin is one parameter with higher inter laboratory variability since its discovery till today. Hence more quality methods are to be developed to minimize this bias in clinical interpretation of reported bilirubin levels. Our study is an intermediary quality measure useful for both clinicians and lab personnel. This study can be adopted for retrospective quality evaluation and can be adopted for other parameters as well.

BACKGROUND Potential conditions that predispose babies to being small at birth are quite common in tropical practice. Several factors may predispose to SGA delivery. 1 Maternal factors known to contribute to foetal malnutrition (FM) include biological factors, nutritional factors, brief interpregnancy intervals, low socioeconomic class, poor education, medical and obstetric problems. The main aim of the study was to assess whether maternal factors are influencing the nutritional status of foetus. MATERIALS AND METHODS The present study is undertaken at Niloufer Hospital for Children, Osmania Medical College, a tertiary paediatric care centre to assess the nutritional status of new born at birth. The study included a total of 125 neonates born to mothers who have completed 38 weeks of gestational age. Neonates with major congenital malformations were excluded from the study. CAN Score was calculated for all the babies. Maternal data of the mothers of these babies is recorded in detail. RESULTS The association between the nutritional status and each factor of maternal data is checked with both CAN Score cutoff points at <24 and < 21. 63.34% of the babies born to primi para mothers had foetal malnutrition and 73.33% of the babies born to mothers with low haemoglobin levels had FM with CAN Score cutoff of ≤ 24. CONCLUSION Maternal factors and her nutritional status play a major role in the birth size of a baby. Maternal biological factors which may influence FM include parity, maternal haemoglobin and mode of delivery.

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