Prediction of Neonatal hyperbilirubinemia by The Cord Blood Alkaline ‎Phosphatase

Abstract

Background: Owing to early discharge of neonates from the hospital, the readmission rate has been increased. Therefore, early detection of jaundice and prompt measures are important. Measurements of bilirubin and alkaline phosphatase levels in cord blood have been used for this function. The aim of the work: To assess the cord blood alkaline phosphatase value in predicting neonatal jaundice. Patients and Methods: This study carried out during the period from August 2019 to January 2020 in pediatric department [Al-Azher University Hospital in Damietta]. This study included a total of 101 term infants with gestational age between 37 and 42 weeks, weighing more than 2500g born to healthy mothers. We performed an assessment of the complete medical history [maternal history and neonatal history]. Cord blood samples were collected for measurement of alkaline phosphatase. Neonates were followed-up for the emergence of jaundice. Infants with clinical jaundice were recalled and serum bilirubin level was measured. Significant indirect neonatal hyperbilirubinemia was considered. Results: The study showed that patients with neonatal jaundice had statistically significant higher reticulocyte count, alkaline phosphate level and total bilirubin than patients without neonatal jaundice. However, the study shows the best cut-off points of regarding ALP to predict neonatal jaundice in neonates. A value of 200 or more IU/L was the best cut-off point to predict occurrence with a sensitivity of 98.3%, a specificity of 97.6%. Conclusion: Increased alkaline phosphatase level in cord blood act as an indicator to neonatal jaundice, and may be used as a marker for early diagnosis.

Keywords

• alkaline phosphatase
• enzyme
• bilirubin
• neonate
• hyperbilirubinemia