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

Abstract

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.