A study to determine the level of cord blood albumin in predicting neonatal jaundice

Abstract

Background: Most unconjugated bilirubin formed by the fetus is cleared by the placenta into the maternal circulation. Albumin constitutes 70 - 75% of Plasma oncotic pressure. Another important function of albumin is its antioxidant property. Bilirubin binds to albumin in an equimolar ratio. Free bilirubin is anticipated when the molar bilirubin- to- albumin (B: A) ratio is >0.8 Objective of the study was to predict the proportion of newborn requiring intervention for NH (phototherapy or exchange transfusion) based on cord serum albumin level at birth.Methods: The present prospective study was conducted at Navodaya Medical College, Raichur from October 2018 to November 2019. A total of 180 babies which were born during the study period were included in the study. INCLUSION CRITERIA• Term babies both genders• Mode of delivery (normal and C-section)• Birth weight ≥2.5kg.• APGAR ≥7/10 at 1 min. Cord Serum Albumin level was estimated at birth. Total Serum Bilirubin (TSB) estimation was done at 72-96 hours of age. All the babies were followed up daily for first 4 postnatal days and babies were daily assessed for NH and its severity.Results: In our study nearly 54.4% of them had Cord Serum Albumin levels of less than 2.8 gm/dl, 27.3% of them had albumin levels of 2.9 to 3.3 gm/dl, 18.3% of them had Serum Albumin of 3.4 gm/dl. Out of 180 study subjects, 13.9% of them required phototherapy to treat neonatal hyper bilirubinemia and 2.8% of the study subjects required exchange transfusion.Conclusions: From the present study, cord serum albumin level of ≤2.8g/dl has a correlation with incidence of significant hyperbilirubinemia in term newborns. So, this ≤2.8g/dl of cord serum albumin level can be used as risk indicator to predict the development of significant hyperbilirubinemia.

Association of neonatal hyperbilirubinemia with cord albumin among term appropriate for gestational age neonates

“…In this study we have found that there is no gender predilection for the development of NH (p=0.122) which was supported by most of the studies. 18,19,[26][27][28][29]31,33 In this study, study group is uniformly distributed with 60 male and 82 female babies. There is no significant correlation (p=0.122) in the TSB levels and the sex of the newborn.…”