Cord Blood Alkaline Phosphatase as an Indicator of Neonatal Jaundice

Ahmadpour-Kacho, Mousa; Pasha, Yadollah Zahed; Haghshenas, Mohsen; Rad, Zahra Akbarian; Firouzjahi, Alireza; Bijani, Ali; Dehvari, Abdollah; Baleghi, M

doi:10.5812/ijp.718

Cited by 8 publications

(3 citation statements)

References 13 publications

(14 reference statements)

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“…During phototherapy, 77.6% of neonates revealed a rise in serum zinc levels to the extent that 41.2% had elevated serum zinc levels up to abnormal. This result is consistent with the other investigations (10)(11)(12)(13). The mechanism between zinc level and phototherapy has been investigated in previous studies (4,14,15).…”

Section: Discussionsupporting

confidence: 93%

Zinc level alternation after phototherapy in neonates with hyperbilirubinemia

et al. 2023

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Introduction: One of the old treatment methods for unconjugated hyperbilirubinemia in neonates is blood exchange transfusion, which is expensive, possibly high-risk, and time-consuming. Today phototherapy as a novel method can be a good alternative. Objectives: This study aimed to evaluate the zinc level alternation after phototherapy in neonates with hyperbilirubinemia. Patients and Methods: A descriptive-analytical study was conducted on 85 infants with hyperbilirubinemia who underwent phototherapy referred to the pediatric hospital in Bandar- Abbas, Iran from 2017 to 2018. Healthy infants over two days with idiopathic jaundice with a gestational age greater than 34 weeks and only breast-feed were enrolled. Serum zinc levels were measured before and after phototherapy, and their changes were evaluated. Results: Out of 85 neonates, 42 (49.4%) were male and 43 (50.6%) were female with a mean gestational age of 37.83 ± 0.58 weeks and admission age of 4.15 ± 1.70 days. Zinc level before phototherapy was 84.98 ± 52.06 (μg/dL) and after phototherapy was 234.41 ± 280.98. The difference between serum zinc levels before and after the phototherapy was significant therefore, the zinc level significantly increased after the phototherapy. Conclusion: Results showed that phototherapy increases serum zinc levels, which can cause zinc toxicity. It is wise to measure serum zinc levels before and during phototherapy and seek the appropriate medical care.

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Section: Discussionsupporting

confidence: 93%

Zinc level alternation after phototherapy in neonates with hyperbilirubinemia

et al. 2023

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“…In 2015 Mousa Ahmadpour-Kacho et al, [13] did the study to find a relation between cord blood alkaline phosphatise and newborn who develop neonatal hyperbilirubinemia. Study shows a significant result when cord blood alkaline phosphatase and serum bilirubin where compared with p value 0.041 and cut off value >314 IU/L associated with 80 % sensitivity and 63 % specificity.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Hyperbilirubinemia - Early Detection with Umbilical Cord Blood Bilirubin and Umbilical Cord Blood Alkaline Phosphatase Levels - Individual vs Combined Predictive Markers

Singh¹,

K²,

Narang³

2020

SJM

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Background:To assess the significance of umbilical cord blood alkaline phosphatase and umbilical cord blood bilirubin as a combined marker for prediction of neonatal hyperbilirubinemia. Methods: The present study was conducted in department of Pediatrics, Mata Chanan Devi Hospital, Janakpuri, New Delhi between march 2018 to september 2019 included 370 healthy full term newborns fulfilling inclusion and exclusion criteria. The cord blood alkaline phosphatase level and cord blood bilirubin level were measured at birth. All the neonates were clinically observed for the development of jaundice for 5 days and serum bilirubin level estimation was done as and when required. Significant hyperbilirubinemia was considered when serum bilirubin level in term newborns was more than or equal to 12 mg/dl at 24 hrs of life, 15 mg/dl at 48 hrs, and 17 mg/dl at 72 hrs. Results: Out of 370 cases, 58 neonates developed significant hyperbilirubinemia i:e 16%. 28 babies had ABO incompatibility out of which 11 had significant hyperbilirubinemia (p=0.002) and 23 babies had RH incompatibility out of which 11 developed significant hyperbilirubineia (p <0.001). Mean ± SD cord blood bilirubin level in no significant hyperbilirubinemia group and significant hyperbilirubinemia group was 1.63±0.44 mg/dl and 2.49±0.22 mg/dl respectively with statistical analysis (p <0.001). There is no significant difference of cut off value of cord ALP level at 140.5 IU/L between significant and non significant hyperbilirubinemia group (p=0.398). Among Neonates with significant hyperbilirubinemia 55.18% were having cord blood bilirubin level >2.205mg/dl and cord blood ALP level >140.5 IU/L, in remaining 44.82% the cord blood bilirubin level was ≤2.205 mg/dl and cord blood ALP level was ≤140.5 IU/L and combined statistical analysis showed significant neonatal hyperbilirubinemia (p<0.001). Conclusions: Our study showed no significant association between cord blood ALP level and neonatal hyperbilirubinemia. Optimum cut off level of umbilical cord blood bilirubin was 2.205 mg/dl with high sensitivity (91.4%) and specificity (94.9%) to predict significant neonatal hyperbilirubinemia with positive predictive value was 76.8% and the negative predictive value was 98.3%. Combined cord blood alkaline phosphatase (cut off level 140.5 IU/L) and cord blood bilirubin (cut off level 2.205mg/dl) showed significant association with neonatal hyperbilirubinemia (p<0.001) with sensitivity of 55.2%, increase in specificity to 97.1% and also slight increase in positive predictive value to 78%. Combined negative predictive value of cord blood blirubin and alkaline phosphatase is 92.1%.

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“…Alkaline phosphatase placed among group of hydrolase enzymes is present in almost all body cells including RBCs and removes phosphates from them 21 . Increase in alkaline phosphatase represents cholestasis.…”

Section: Page-208mentioning

confidence: 99%

Effect of Raphanus Sativus (Radish) Leaf Extract on Atorvastatin Induced Hepatotoxicity in Rabbits

Anwar¹,

Iqbal²,

Chiragh³

et al. 2018

J. Bahria Uni. Med. Dent. Coll.

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Objectives: To investigate hepato-protective effect of ethanolic leave extract of Raphanus sativus against atorvastatin induced hepatotoxicity in albino rabbits. Study design: Experimental study Material and Method: This study conducted at department of Physiology and Pharmacology, University of Agriculture, Faisalabad. The ethanolic extract of Raphanus sativus was prepared for hepatoprotective effect against hepatotoxicity produced by atorvastatin. Results: The results were compared with normal and experimental control. Serum was tested for ALT, AST, Alkaline Phosphatase and Bilirubin along with histological studies. Ethanolic extract of Raphanus sativus with 100mg/kg. of body weight dosage developed some changes representing hepatotoxicity but higher doses showed an increase in toxicity as observed on histologic sections. A reduction in fibrosis and cholestasis was observed which needs further evaluation. Conclusion: Ethanolic extract of raphanus sativus did not show any amelioration in the increased enzymes level however a reduction in cholestasis was observed as represented by decreases in alkaline phosphatase levels also confirmed by histological studies.

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Cord Blood Alkaline Phosphatase as an Indicator of Neonatal Jaundice

Cited by 8 publications

References 13 publications

Zinc level alternation after phototherapy in neonates with hyperbilirubinemia

Zinc level alternation after phototherapy in neonates with hyperbilirubinemia

Neonatal Hyperbilirubinemia - Early Detection with Umbilical Cord Blood Bilirubin and Umbilical Cord Blood Alkaline Phosphatase Levels - Individual vs Combined Predictive Markers

Effect of Raphanus Sativus (Radish) Leaf Extract on Atorvastatin Induced Hepatotoxicity in Rabbits

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