Correlation Between Cord Serum Albumin and Total Serum Bilirubin in Term Newborn with Neonatal Hyperbilirubinemia: A Prospective Observational Study

Abstract

A BSTRACT Neonatal hyperbilirubinemia (NHB) frequently occurs due to underdeveloped liver and excess breakdown of rapidly degrading red blood cells. The risk of bilirubin toxicity is increased by reduced albumin levels, highlighting its role in early diagnosis. This study evaluated the correlation of cord serum albumin (CSA) with total serum bilirubin (TSB) level as well as the role of CSA as an early predictor of NHB. This prospective observational study involved 92 full-term healthy neonates admitted in the Paediatric Department of a tertiary care institute. Based on the CSA levels, neonates were divided into three groups: Group A, B, and C with levels <2.8, 2.8 to 3.4, and >3.4 gm/dL, respectively. TSB levels were assessed at 24 and 96 hours of life. NHB was present in 19.6% neonates. Significantly greater proportion of patients in Group A had NHB compared to Groups B and C ( P < 0.001). At 24 and 96 hours, Group A had higher TSB levels than Group B and C ( P < 0.0001) and Group B had higher levels than group C ( P < 0.0001). CSA levels were negatively correlated with TSB levels at 24 ( r = –0.93, P < 0.05) and 96 hours ( r = –0.92, P < 0.05). CSA was a significant predictor of NHB (OR = 0.01, 95% CI: 0.001-0.094, P < 0.0001). At a cut-off of 2.15 g/dL, ROC curve analysis revealed that CSA had sensitivity of 95.9% and specificity of 88.9% in prediction of NHB (AUC = 0.973, 95% CI = 0.939-1.000; P < 0.0001). CSA is inversely related with TSB and CSA levels demonstrated a strong role in prediction of NHB.