National Journal of Laboratory Medicine (Oct 2017)
Neonatal Hyperbilirubinemia-Evaluation of Total Calcium, Ionised Calcium, Magnesium, Lactate and Electrolytes
Abstract
Introduction: A total serum bilirubin level above 5 mg/dL in neonates is defined as neonatal hyperbilirubinemia. In the first week of life around 60% of term and 80% of preterm babies develop jaundice, and at 1 month about 10% of breastfed babies are still jaundiced. This condition is associated with a wide variety of biochemical disturbances. Aim: To study the biochemical disturbances in babies with indirect hyperbilirubinemia. Materials and Methods: We studied 82 babies with unconjugated hyperbilirubinemia and compared 82 normal healthy term babies. All birth details and biochemical investigations including serum bilirubin, lactate levels, total calcium, ionized calcium, magnesium, urea, and creatinine were recorded in a prestructured proforma. Descriptive statistics, Pearson’s correlation and Student’s ‘t’ test was used for analysis of data. Results: We found that females were 42.7% and males were 57% indicating a male preponderance in the case group. Unconjugated hyperbilirubinemia was more common in babies born by caesarean section (65.8%) and babies born at gestation <35 weeks (52.43%). The average birth weight of these babies was 2.1 kg. Mean magnesium value in the control group was 2.12 mg/dL, compared to 2.13 mg/dL in babies with indirect hyperbilirubinemia. Lactate values were slightly higher than the reference range in these babies. Levels of urea, phosphorous, sodium potassium and chloride were significantly higher in hyperbilirubinemia babies. Levels of total calcium were significantly lower. Ionised calcium and creatinine were found to be decreased and magnesium was increased in babies with indirect hyperbilirubinemia but results are not significant. Conclusion: We noted that total calcium was decreased significantly but changes in levels of ionized calcium and magnesium were not significant in babies with indirect hyperbilirubinemia.
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