Cord blood Bilirubin as a predictor of Neonatal Hyperbilirubinemia

Abstract

Background: Bilirubin is an antioxidant that protects newborns against free radicals during the first days of their lives, but at high levels is neurotoxic and causes brain damage. In this study we aimed to determine whether the measurement of bilirubin level in noninvasively taken cord blood could be a predictor of a pathological jaundice requiring medical treatment. Methods: Cord blood and a control sample taken on the third day of life were taken from 185 healthy full-term newborns of both genders. Bilirubin levels were determined according to the Jandrassik-Grof method. Statistical characteristics were calculated using statistic programs ANOVA and t-test. Results: 117 (63.2 %) of the newborns had physiological jaundice with 28 ± 7.8 μmol/L bilirubin in cord blood, and 68 (36.8 %) had pathological jaundice with 35 ± 7.8 μmol/L bilirubin. 20 (10.8 %) newborns had been treated by phototherapy, and had levels of 40 ± 8.5 μmol/L bilirubin. Differences in cord blood bilirubin levels between groups were statistically significant (p < 0.001). Taking a cut-off value of 28 μmol/L cord blood bilirubin level, pathological jaundice can be predicted by 85.3 % and whether newborns require treatment or not by 100 % clinical sensitivity. Conclusions: The results of our study confirm that measurement of cord blood bilirubin level can be used as a screening test for predicting the development of pathological jaundice that requires medical treatment.