Abstract

Introduction

The incidence of jaundice in neonates is around 65-70% in Western world¹. and may be higher among newborns of Asian ethnicity. Neonatal jaundice is well known to be associated with increased unconjugated bilirubin concentrations which is caused by the breakdown of red blood cells. Bilirubin damages neurologic tissue and leads to neurologic dysfunction.² Bilirubin in itself is not detrimental and exerts a physiological protective effect due to its antioxidant properties. Previous studies have highlighted the relationship between bilirubin and nitric oxide, reactive oxygen/nitrogen species.

The American Academic of Pediatrics (AAP) recommends that newborns discharged within 48 h should have a follow-up visit after 48-72 h for any significant jaundice or other problems.2 In developing countries, follow-up is questionable as mothers do not return because of negligience and distance they need to travel. This may delay the diagnosis of severe neonatal hyperbilirubinemia and thereby causing an increase the incidence of kernicterus. Therefore, several attempts have been made to identify predictors of neonatal hyperbilirubinemia to assist in the early detection of neonates at high risk of severe hyperbilirubinemia. The hour-specific bilirubin nomogram is widely accepted by most clinicians, but has a low sensitivity and may vary by ethnicity. Studies have been performed to assess the ability of cord bilirubin and albumin and first day bilirubin levels as tools for screening of subsequent neonatal hyperbilirubinemia. In the present study we aimed at determining the critical cord serum bilirubin and albumin level that predict significant hyperbilirubinemia in healthy term newborns based on serum bilirubin measurements made within 5 days of life.