Role of Cord Blood Alkaline Phosphatase as a Predictor for Hyperbilirubinemia in Full-term Neonates

Abstract

Background: Neonatal hyperbilirubinemia is a common clinical condition among newborns that requires early detection and medical management to avoid bilirubin toxicity. This study aimed to investigate the role of cord blood alkaline phosphatase (ALP) levels as a predictor of hyperbilirubinemia in full-term neonates. Methods: This cross-sectional study was conducted on full-term newborns within April-August 2019 in several hospitals in Medan, Indonesia. Cord blood ALP levels upon delivery and serum bilirubin levels on 72 h of life were measured. Results: Out of 147 full-term neonates, the mean cord blood ALP levels and serum bilirubin levels were obtained at 166.3±45.1 IU/l and 9.6±2.3 mg/dl, respectively. There was a significant difference in mean cord blood ALP levels at serum bilirubin levels of >10 mg/dl and ≤10 mg/dl on 72 h of life (196.8±40.7 IU/l and 146.4±37.5 IU/l, respectively; P=0.001). A positive, moderate, and significant correlation was observed between cord blood ALP levels and serum bilirubin levels on 72 h of life (r=0.429; P=0.001). The cut-off value of 163.5 IU/l was associated with 84.7% sensitivity and 77.3% specificity for predicting hyperbilirubinemia in full-term neonates. Conclusion: There was a positive correlation between cord blood ALP levels and serum bilirubin levels on 72 h of life. Therefore, cord blood ALP may be utilized as a predictor for hyperbilirubinemia in full-term neonates.

Keywords

• alkaline phosphatase
• hyperbilirubinemia
• full-term neonates