Utility of Cord Blood Albumin as a Predictor of Significant Neonatal Jaundice in Healthy Term Newborns
Jitendra Kumar Meena, Surjeet Singh, Chaman Ram Verma, Rambabu Sharma.
Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, Rajasthan, India.
Aim: To study the association between cord blood albumin level and subsequent development of significant neonatal jaundice (NNJ) in healthy term newborns.
Methods and Materials: A prospective study was done in 100 sequentially born healthy term babies (gestational age > 37 weeks) of either gender, from any mode of delivery, with any birth weight, Apgar score ≥7 at first and fifth minutes of life, without ABO and Rh incompatibility. They were divided into 3 groups A, B, and C according to cord blood albumin levels < 2.8 gm/dl, 2.8-3.3 gm/dl and >3.3 gm/dl respectively and then followed clinically for jaundice upto day 5 of life or till hospital stay whichever was later. Wherever necessary further laboratory tests were done and baby managed accordingly.
Results: Group A, B, and C had 22, 34, and 44 newborns respectively. In group A, 21 (95.5%) neonates developed jaundice, of which 18 (81.8%) required phototherapy and 2 (9.1%) needed exchange transfusion; whereas 27 (79.4%) neonates in group B developed jaundice, of which 9 (26.6%) needed phototherapy and none required exchange transfusion. In group C 16 (36.6%) developed jaundice of which 1 (2.4%) required phototherapy and none of them required exchange transfusion (p value <0.001).
Conclusion: Umbilical cord serum albumin levels are useful in predicting subsequent neonatal jaundice in healthy term newborns. Neonates with cord blood albumin levels > 3.3 gm/dl are probably safe for early discharge whereas neonates with albumin levels <3.3 gm/dl will need a close follow up to check for development of jaundice.
