الفهرس 
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Abstract
Neonatal jaundice is a very common condition worldwide occurring in up to 60% of term and 80% of preterm newborns in the first week of life. Even though extreme hyperbilirubinaemia is rare in developed countries it is still quite rife in developing countries often resulting in kernicterus with its attendant medical, economic and social burden on the patient, family and society (Onyearugha et al., 2011).
Before discharge, every newborn should be assessed for the risk of developing severe hyperbilirubinemia, and all nurseries should establish protocols for assessing this risk. Such assessment is particularly important in infants who are discharged before the age of 72 hours )A.A.P 2004).
Albumin is a plasma protein synthesized by the liver and it helps in transport of unconjugated bilirubin. It is the major binding protein in the human neonate. Low production of albumin will lower bilirubin transport and binding capacity (Sgro et al., 2006).
The aim of the study is To assess predictive value of cord serum bilirubin and albumin for significant neonatal hyperbilirubinemia.
Our prospective study was conducted on 36 neonates in delivery room and NICU in Zagazig university hospitals. They were retrospectively classified into 2 groups; group I (neonates needed NICU admission to treat their jaundice by phototherapy) as cases group which included 9 neonates and group II (neonates without significant neonatal jaundice) as a control group which included also 27 neonates.
Investigations done at birth were cord serum albumin level, cord serum bilirubin (direct & indirect), complete blood picture, serum C_reactive protein (CRP), maternal & neonatal blood group and RH. On the 3rd day post natal investigations had been done was serum bilirubin (direct & indirect). Other investigations were done according to the case for example reticulocytic count in suspected hemolysis, random blood sugar in cases of infants of diabetic mothers.
There is a statistically significant difference between case group and control group regarding total cord bilirubin where it is higher in case group than control group. Also there is a statistically significant difference between case group and control group regarding cord albumin level where it is higher in control group than case group.
In our study we subgrouped our neonates according to their cord albumin level into 3 groups; the 1st group which has cord albumin level less than 2.8 gm/dl, the 2nd group is from 2.8-3.3 gm/dl and the 3rd group which has cord albumin more than 3.3 gm/dl.
In the studied groups we found that 85% of newborns with cord albumin level less than 2.8 gm/dl developed significant hyperbilirubinemia and all of them required phototherapy except one required exchange transfusion. The group of newborns with cord albumin level 2.8-3.3 gm/dl, 40% of them developed significant hyperbilirubinemia; all of them required phototherapy and no one required exchange transfusion. The group of newborns with cord albumin level more than 3.3 gm/dl, none of them developed significant hyperbilirubinemia which required phototherapy and also no one required exchange transfusion.