Cord blood albumin–bilirubin as a predictor for neonatal hyperbilirubinemia

Mashad, Ghada M El; Sayed, Hanan M El; Shafie, Wael A El

doi:10.4103/mmj.mmj_13_18

Cited by 7 publications

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“…We chose to employ those combined as the CBB to CBA ratio so as to achieve a greater sensitivity, specificity, NPV, and PPV than either CBB or CBA individually. Cut-off points of the CBB/CBA ratio attained in other studies 27–30 for the prediction of the development of significant hyperbilirubinemia were 0.60, 0.78, and 0.98. ROC curve estimation on the CBB/CBA ratio showed a cut-off point of 0.630 with a sensitivity of 91.66%, specificity of 86.84%, PPV of 68.75%, and NPV of 97.05%.…”

Section: Discussionmentioning

confidence: 78%

Prediction of Neonatal Hyperbilirubinemia from Cord Blood Bilirubin and Cord Blood Albumin Ratio in Healthy Term Indian Neonates

Kosigi,

2023

Journal of Neonatology

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Background Neonatal jaundice affects 85% term and most of the preterm infants. Unconjugated bilirubin is bound by albumin, which promotes its transit and lessens bilirubin toxicity, thereby serves as early determinant for the risk of pathological hyperbilirubinemia among neonates. Present study was undertaken to know the utility of cord blood bilirubin (CBB), cord blood albumin (CBA), and their ratio at time of birth for the development of significant neonatal hyperbilirubinemia. Objectives To evaluate CBB/CBA ratio at the time of delivery as potential predictive factor for the development of significant neonatal hyperbilirubinemia and compare this with CBB and CBA alone. Study Design Prospective observational analytical study. Participants Total 178 inborn term neonates delivered during 3-month time period (22nd October, 2022−22nd January, 2023). Interventions Cord blood sample was collected at birth for CBA, CBB, and blood grouping/phenotyping. Transcutaneous bilirubin (TCB) measurements were done 12 hourly in all babies for the first 7 days of life/till discharge, and also in the case of development of significant clinical jaundice. For TCB values above cut-off, serum total bilirubin was done and need for phototherapy (PT) decided based on cut offs suggested in AAP 2004 nomograms. Results Cut-off values of CBB and CBA as obtained by the receiver operating characteristic (ROC) curves were 1.98 mg/dL and 3.14 g/dL, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CBB were 83.33%, 63.15%, 41.66%, and 92.30%, while for CBA, 41.66%, 71.05%, 31.25%, and 79.41%. CBB/CBA cutoff ratio was 0.630 with 91.66% sensitivity, 86.84% specificity, 68.75% PPV, and 97.05% NPV. Conclusions Compared to CBB and CBA alone, CBB/CBA ratio has greater sensitivity, specificity, PPV, and NPV and it may serve as a better indicator for prediction of pathological hyperbilirubinemia in neonates.

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Section: Discussionmentioning

confidence: 78%

Prediction of Neonatal Hyperbilirubinemia from Cord Blood Bilirubin and Cord Blood Albumin Ratio in Healthy Term Indian Neonates

Kosigi,

2023

Journal of Neonatology

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“…Likewise, a lower serum albumin level was documented in a study on serum albumin concentration and clinical disorders by gestational ages in newborn babies by Lee et al [33] in South Korea. In the same vein, Khairy et al [32] and Mashad et al [34] in Egypt reported cord albumin levels of 3.30 ± 0.50 g/dl and 2.76 ± 0.71 g/dl respectively which were lower than the cord albumin levels of 4.49 ± 1.12 g/dl documented by Abdurrahman et al [35] in Nigeria. These findings corroborate earlier remarks that genetic variation may be responsible for the higher serum albumin values documented in the present study despite the presence of hyperbilirubinemia [3,12,[28][29][30]36].…”

Section: Discussionmentioning

confidence: 79%

Utilizing the Bilirubin-Albumin Ratio as a Predictive Marker for Bilirubin-Induced Neurologic Dysfunction: A Comparative Analysis in Two Referral Hospitals in Abeokuta

Alaba,

Dedeke,

Agbo

2024

JAMMR

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Aim: We aim to assess the predictive value of Bilirubin Albumin Ratio (BAR) for evaluating bilirubin-induced neurologic dysfunction (BIND). Bilirubin-induced neurologic dysfunction is a major cause of morbidity in neonates with highest burden in Sub-Saharan Africa and other resource-limited settings. Bilirubin Albumin Ratio (BAR) has been purported to correlate better with BIND than total serum bilirubin (TSB) which is the conventional tool used in evaluating babies with severe hyperbilirubinemia. There is however paucity of studies utilizing BAR in evaluating BIND. Study Design: The study design was cross-sectional. Place and Duration of Study: Neonatal Units of two referral hospitals; Federal Medical Centre Abeokuta and Sacred Heart Hospital Abeokuta in Ogun State, Nigeria between October 2019 – May 2020. Methods: We included 84 late preterm and term babies with severe hyperbilirubinemia in the first 14 days of life. Babies were grouped into those with and without BIND using the modified BIND score, their sera was assessed for total serum bilirubin, and albumin and the BAR was calculated by dividing the plasma bilirubin level by serum albumin and findings were compared between the two groups. Results: Bilirubin-induced neurologic dysfunction was present in 67.9% of babies with severe hyperbilirubinemia with a male: female ratio of 1.8:1. The mean BAR for babies with and without BIND were 7.77 ± 1.76 and 5.43 ± 1.27 mg/g respectively. Babies with BIND had a significantly higher BAR than those without BIND (p < .001). Using the receiver operating characteristic curve analysis, the cut-off value for BAR was 6.46 mg/g with sensitivity, and specificity of 84.2% and 81.5% respectively. Conclusion: The prevalence of BIND among babies with severe hyperbilirubinemia is high and BAR has a high predictive value in evaluating babies at risk of developing BIND.

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“…Theo y văn, khi có tình trạng giảm khả năng liên kết giữa bilirubin gián tiếp với albumin, bilirubin gián tiếp ở dạng tự do có thể tăng lên ở trong dịch ngoại bào một cách độc lập với nồng độ bilirubin toàn phần. Nguyên nhân thường gặp là do nồng độ albumin máu thường thấp ở trẻ sinh non hoặc một số trẻ có huyết tương chứa chất làm giảm khả năng gắn kết của bilirubin với protein của huyết tương (các chất như hematin, sulfonamid, salicylate, caffein natri benzoat và tăng H + … [7]. Khi bilirubin gián tiếp ở dạng tự do càng tăng thì nguy cơ biến chứng vàng da nhân càng tăng [3].…”

Section: Bàn Luận 41 Giá Trị Tiên đOán Vàng Da Bệnh Lý Của Albumin Má...unclassified

“…Tuy nhiên cũng có một số nghiên cứu của các tác giả khác lại ghi nhận kết quả ngược lại, cho thấy albumin máu cuống rốn có giá trị tiên đoán vàng da bệnh lý như: Mashad và cs (2019) ghi nhận nếu CBA < 2,8 g/dl có 81,8% trẻ có vàng da bệnh lý, nếu CBA > 3,3 g/dl thì 100% trẻ không bị vàng da bệnh lý, tại điểm cắt CBA < 2,75 g/dl có AUC 0,805 [7]; Chandel và cs (2020) nghiên cứu trên 40 trẻ sinh non > 32 tuần và 66 trẻ đủ tháng ghi nhận tỷ lệ vàng da bệnh lý ở nhóm trẻ sinh non là 58,6% và khi CBA < 3,3 g/dl sẽ có giá trị tiên đoán vàng da bệnh lý với Se 97,6%, Sp 43,8% với p < 0,01 [10]. Roach và cs (2022) nghiên cứu trên 200 trẻ (94 trẻ đủ tháng và 106 trẻ sinh non) nhận thấy nhóm trẻ sinh non có CBA < 2,8 g/dl có tỷ lệ vàng da bệnh lý cao hơn nhóm sinh non có CBA > 2,8 g/dl với p=0,02 [11].…”

Section: Bàn Luận 41 Giá Trị Tiên đOán Vàng Da Bệnh Lý Của Albumin Má...unclassified

Value of cord blood albumin and bilirubin in the prediction of pathological hyperbilirubinemia in preterm neonates

Thanh

Hung

2023

JMP

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Background: Preterm infants have a higher incidence of indirect hyperbilirubinemia than term infants in about 80% of cases. Approach to initial screening for hyperbilirubinemia in preterm infants by cord blood is practical, cheap and noninvasive. Objectives: To determine the value of cord blood albumin, bilirubin and bilirubin/albumin ratio to predict pathological hyperbilirubinemia in preterm infants. Materials and method: A prospective cohort study was carried out all preterm infants < 37 weeks, were born at Hospital of University of Medicine and Pharmacy, Hue, Viet Nam from 4/2018 to 8/2020. Cord blood albumin and bilirubin was collected after birth. Neonates were followed up daily for hyperbilirubinemia. Check serum bilirubin levels on the second day after birth and whenever an infant has significant hyperbilirubinemia. Results: We studied 176 preterm infants with jaundice, 88/176 (50%) infants had pathological hyperbilirubinemia. At the cut-off point for total cord bilirubin > 1.818 mg/dl and bilirubin/albumin ratio > 0.518 had a good predictive in detecting pathological hyperbilirubin in preterm infants with an AUC 0.854 and 0.842 respectively. However, cord blood albumin had no predictive value with an AUC of 0.524. Conclusion: Cord blood bilirubin and bilirubin/albumin ratio have a good discrimination in predicting pathological hyperbilirubinemia in preterm infants Key words: neonate, preterm, hyperbilirubinemia, cord blood albumin, cord blood bilirubin, bilirubin/albumin ratio.

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Cord blood albumin–bilirubin as a predictor for neonatal hyperbilirubinemia

Cited by 7 publications

References 0 publications

Prediction of Neonatal Hyperbilirubinemia from Cord Blood Bilirubin and Cord Blood Albumin Ratio in Healthy Term Indian Neonates

Prediction of Neonatal Hyperbilirubinemia from Cord Blood Bilirubin and Cord Blood Albumin Ratio in Healthy Term Indian Neonates

Utilizing the Bilirubin-Albumin Ratio as a Predictive Marker for Bilirubin-Induced Neurologic Dysfunction: A Comparative Analysis in Two Referral Hospitals in Abeokuta

Value of cord blood albumin and bilirubin in the prediction of pathological hyperbilirubinemia in preterm neonates

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