Association of cord serum albumin with neonatal hyperbilirubinemia among term appropriate-for-gestational-age neonates

INTRODUCTION: Neonatal jaundice affects nearly 60% of term and 80% of preterm neonates during the first week of life. Although early discharge of healthy term newborns is a common practice, neonatal hyperbilirubinemia (NH) is the most common cause for readmission during the early neonatal period. OBJECTIVE: To determine the association of cord serum albumin with serum bilirubin levels and whether it can be used as a risk indicator for the development of NH. METHOD: In this observational study, cord blood was collected from healthy term newborns for serum albumin level measurements. Total serum bilirubin and direct serum bilirubin were measured during 72–96 h of life. Newborns were clinically assessed daily for NH or for any other complication during the study period. RESULT: Among the study cohort of 300 babies, 35 had a total serum bilirubin level of ≥17 mg/dl after 72 h and were considered to have NH. They were grouped as Group 1, Group 2, and Group 3 according to the cord serum albumin level ≤2.8 g/dl, 2.9–3.3 g/dl, and ≥3.4 g/dl, respectively. Statistical analysis was conducted to assess the correlation of cord serum albumin with NH. The results showed that a cord serum albumin level ≤2.8 g/dl is critical, as it was seen in 95% of term newborns who developed NH. In the group where cord serum albumin was ≥3.4 g/dl, none of the term newborns developed NH. CONCLUSION: Term neonates with hyperbilirubinemia with a total serum bilirubin level ≥17 mg/dl had levels of cord serum albumin of ≤2.8 g/dl, and this can be used as a risk indicator to predict the development of NH.