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

Abstract 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.