Cord Bilirubin level as predictor of Clinically significant Neonatal Hyperbilirubinemia.

Introduction: The most common cause of neonatal jaundice is physiological jaundice which usually subside on its own and doesn’t require any specific treat-ment. However, in some instances there can be significant increase in serum bili-rubin level causing clinically significant jaundice requiring neonatal intensive care admission for management of jaundice. It is important to predict the possibility of occurrence of significant hyperbilirubinemia so as to be able to either delay the discharge of neonate or to call patient for early follow up. Materials And Methods: 80 consecutively born full term neonates were in-cluded in this study on the basis of a predefined inclusion and exclusion criteria. At the time of delivery cord blood was sent for estimation of conjugated, unconju-gated and total bilirubin levels as well as blood group. Cord bilirubin level of neo-nate was noted. The neonates were clinically assessed for severity of jaundice by Kramer index. Serum bilirubin level estimation was done. Correlation between umbilical cord bilirubin and later development of neonatal jaundice was studied. P value less than 0.05 was taken as clinically significant. Results: Out of 80 studied cases there were 44 (55%) males and 36 (45%) fe-males with a male to female ratio of 1: 0.81. the most common risk factor was his-tory of previous sibling who required phototherapy for management of neonatal jaundice followed by ABO incompatibility (11.25%), Rh incompatibility (7.50%), onset of jaundice within 24 hrs (12.50%). Significant Cephalhematoma and ma-ternal diabetes was seen in 4 (5%) cases each. neonates who had cord bilirubin levels less than 2mg/dl and more than 2mg/dl showed that amongst 59 neonates with serum bilirubin level of 2mg/dl or less 11 (18.64%) neonates required NICU admissions for management of neonatal jaundice whereas amongst 21 neonates with cord bilirubin level more than 2 mg/dl 14 (66.66%) neonates required NICU admissions for development of neonatal jaundice. Neonates with cord bilirubin level more than 2 were found to have statistically significantly increased chances of NICU admission for management of neonatal jaundice (P