الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 162 |  |  |
| | | from | 162 | | |
Abstract
Neonatal hyperbilirubinemia is observed during the first week of life in approximately 60% of term infants and 80% of preterm infants.
The aim of our study was to assess whether levels of cord blood albumin and bilirubin at birth could be indicative for development of significant hyperbilirubinemia in neonates ≥35 weeks gestation.
We conducted this prospective cohort study on 75neonates≥35 weeks gestation .The mean gestational age was 37.26 ±4.28 wks. Their mean birth weight was 2.87 ± 0.58kg. Significant hyperbiliru-binemia occurred in 42 cases (56%); forty infants (53.3%) underwent phototherapy; 2 infants underwent exchange transfusion (2.7%) and 33 (44%) needed no intervention at all. In this study among total cases there are 25 cases (33.3%) at high risk for development of significant hyperbilirubinemia as they have ABO or RH blood group incompatibility with their mothers, 18 infants (72%) developed significant hyperbilirubinemia (12 cases ABO &6 cases RH), .Sixteen cases (64%) needed phototherapy and 2cases (8%) needed exchange transfusion.
According the levels of cord blood albumin, we found that at cord albumin < 2.8 g/dl→81.8% of cases(27 cases) developed significant hyperbilirubinemia, at cord albumin 2.8-3.3g/dl→ 46.9% of cases developed significant hyperbilirubinemia, while with levels >3.3mg/dl was considered safe with no incidence of hyperbilir-ubinemia. We performed a ROC curve analysis to find a cut-off point level of cord blood albumin(above which the incidence of hyperbilirubinemia increase), it was 2.75g/dl; with 64.3% sensitivity, 81.8% specificity, PPV 81.8% and NPV 64.3% .
According the levels of cord blood bilirubin in the total group we found that, the highest sensitivity (83.3%) was for cut off value of cord bilirubin (1.88mg/dl) with PPV 72.9%, whilst the highest specificity (84.8%) was for cut off value of cord bilirubin-albumin (-0.6).
In high risk group, the highest sensitivity (88.9%), PPV (94.1%) & specificity (85.7%), for cut off value of cord bilirubin-albumin (-0.82). So we can use the bilirubin-albumin to get the highest combination of bilirubin and albumin.
We recommend that Cord blood albumin & bilirubin can be used as an early useful indicator to predict significant hyperbilirubinemia in neonates.