Prediction of Hyperbilirubinemia in Term Newborns by Umbilical Cord Blood Bilirubin

Abstract

Prediction of Hyperbilirubinemia in Term Newborns by Umbilical Cord Blood Bilirubin

Siwiluck Kanchanabat MD*

Payon Boonyarittipong MD*

Oraya Kreinghirun BNS**

* Department of Pediatrics, BMA Medical College and Vajira Hospital

** Department of Nursing, BMA Medical College and Vajira Hospital

Objective: To evaluate the predictive value of umbilical cord blood bilirubin for subsequent hyperbilirubinemia in term newborns.

Study design: Descriptive study (diagnostic test).

Subjects: Two hundred and eighty nine healthy term newborns, who were born in BMA Medical College and Vajira Hospital during August to October 2009.

Methods: Umbilical cord blood samplings were collected immediately after birth in all subjects. Cord blood bilirubin level was measured. The subjects were evaluated and followed for jaundice during admission. Data were recorded in the recording form for statistical analysis.

Main outcome measures: sensitivity, specificity, positive predictive value, negative predictive value.

Results: There were 48 jaundiced neonates (16.6%), all of whom were treated by phototherapy. In the jaundiced group, umbilical cord blood bilirubin levels was significantly higher than the level of the non-jaundiced group (1.7 + 0.9 mg/dL and 1.3 + 0.7 mg/dL.) The optimum cut off level for prediction of neonatal jaundice using umbilical cord blood bilirubin was > 2.3 mg/dL, which has a positive predictive value of 25.0%, negative predictive value of 84.3%, sensitivity of 14.6% and specificity of 91.3%.

Conclusion: Jaundiced neonates had higher umbilical cord blood bilirubin levels than non-jaundiced neonates. Umbilical cord blood bilirubin level may be useful in predicting subsequent jaundice in term newborns.

Keywords: prediction, hyperbilirubinemia, umbilical cord blood bilirubin

Vajira Med J 2010 ; 54 : 147-157