European Journal of Molecular & Clinical Medicine

BACKGROUND: Neonatal jaundice is observed in 60% of healthy term neonates and about 80% of preterm neonates in the first week of life. Unconjugated jaundice affects the central nervous system and results in kernicterus which causes permanent neurological sequel. So, the importance of early prediction of neonatal jaundice has become important to identify the newborns who intend to develop jaundice.
AIM:  To study the Cord Blood Bilirubin to Albumin Ratio as a surrogate marker for neonatal jaundice.
OBJECTIVE: To evaluate the predictive value of umbilical cord bilirubin to albumin ratio in identifying infants for subsequent jaundice.
METHODOLOGY:  A prospective cross-sectional study was conducted over a period of 6 months in 63 term healthy neonates. Under aseptic conditions, umbilical Cord blood was collected after delivery of the newborn and analyzed for bilirubin and albumin levels and cord blood bilirubin to albumin ratio was measured. Measurement of serum bilirubin was done on the 3rd-5th day of life.
RESULT: Out of 63 newborns 28 were males and 35 were females. 26 newborns were born by LSCS and 37 by vaginal delivery. Our study showed a 24% incidence of neonatal jaundice. 15 out of 63 term neonates have developed jaundice. The cut-off point for CBB by ROC curve analysis was 1.88mg/dl with a sensitivity of 87% and specificity of 80%. The cut-off of 0.61 was observed for CBB/CBA ratio with 93% sensitivity and 90% specificity.
CONCLUSION: Cord blood bilirubin and cord blood bilirubin to albumin ratio CBB/CBA are early predictors of neonatal jaundice but cord blood bilirubin to albumin ratio CBB/CBA ratio is a better surrogate marker to predict significant jaundice in healthy term neonates