Early Predictors of Physiologic Hyperbilirubinemia in Neonates: A Comparison of Three Parameters
Swathi Padankatti, Melpakkam Venkatesan Srinath, Kuruvilla Thomas
Abstract
Background and Aim: Hyperbilirubinemia is a benign, self-limiting condition, related to the developmental state of a neonate. Pathologic hyperbilirubinemia is seldom seen but has the potential to cause kernicterus. With the current focus on early discharge after delivery, rehospitalization of neonates because of hyperbilirubinemia is increasing. Researchers have been searching for a reliable predictor of hyperbilirubinemia that can aid in the planning of safe discharge and early follow-up of neonates. This study aimed to determine if cord blood haptoglobin (Hp) and bilirubin levels and serum bilirubin (SB) level at 24 hours of life can serve as early indicators of physiologic hyperbilirubinemia in full-term, healthy neonates.
Materials and Methods: In this prospective cohort study, the neonates fulfilling the inclusion criteria were monitored clinically and through laboratory investigations. Cord blood Hp and bilirubin and SB levels at 24 and 72 hours of age were estimated.
Results: A total of 132 neonates were enrolled. The incidence of neonatal hyperbilirubinemia was 12.9%, with a bilirubin concentration ≥ 16 mg/dL at 72 hours of life. Cord blood Hp, cord blood bilirubin, and 24-hour SB cutoff values for the incidence of significant hyperbilirubinemia were ≤ 0.25 g/L, ≥ 2.5 mg/dL, and ≥ 6.4 mg/dL, respectively.
Conclusion: Cord blood Hp and bilirubin along with SB at 24 hours of age are all valuable predictors of significant neonatal hyperbilirubinemia at 72 hours of age.
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