Correlation Of Cord Blood Bilirubin And Neonatal Hyperbilirubinemia In Newborns With A Setting Of Abo Incompatibility

Abstract

Background: Neonatal Hyperbilirubinemia (NH) is commonest benign physical finding during the first week of life which require evaluation and treatment. In significant number (6.5%) of newborns, Neonatal Hyperbilirubinemia (NH) is also the most common cause for readmission during the early neonatal period. Umbilical cord bilirubin measurement is a cheap, non invasive, readily available investigation that can help in predicting the development of hyperbilirubinemia in neonates. The aim of this study is to study the correlation of Cord blood bilirubin level with subsequent neonatal hyperbilirubinemia with a setting of ABO incompatibility in neonates.

MATERIALS AND METHOD: 324 healthy term inborn neonates with A, B, or AB blood group born to mother s with O blood group were enrolled in the study, during study period of one and half year. Cord blood was collected from the placental side of cord. Cord and blood bilirubin were estimated. Also Serum Bilirubin (total and indirect) was done from peripheral blood at 24 hours, 48 hours and 72 hours of life.

RESULTS: Incidence of significant hyperbilirubinemia in the study at 24 hours of life was 13%. Mean Serum Bilirubin at postnatal 72 hours of life was 11.1 gm/dl. Using cord blood bilirubin level of > 3 mg/dl as cut-off value, neonatal hyperbilirubinemia can be predicted with sensitivity of 85%, specificity of 93.5%, positive predictive value of 69% and negative predictive value of 98%.

CONCLUSIONS: In the present study a Negative Predictive Value of 98% suggests that in Healthy Term babies with ABO incompatibility having a CBB <3 mg/dl, are unlikely to require further evaluation and intervention. The above patients can be discharged with assurance to patients.