Comparison of cord total bilirubin level with the serum bilirubin at the third day of birth in term newborns in Qazvin Kosar Hospital

Neonatal jaundice is a common problem that leads to many problems such as encephalopathy and hearing loss, kernicterus and death. Due to the importance of preventing the potential complications of hyperbilirubinemia, the present study was performed to determine the level of total cord bilirubin in neonates and to compare with bilirubin three days after birth in Kowsar hospital in Qazvin.

In this prospective cross-sectional study, 100 neonates were evaluated in Kowsar hospital maternity ward and required information was prepared in checklists containing maternal variables (blood group,taking medicine) and the infant's data (name, sex, birth weight, gestational age, breast feeding and formula milk feeding, Apgar score, cord blood bilirubin level, and serum bilirubin level on the third day after birth) were obtained with informed consent and entered into a file by a trained individual. Cord blood samples were also taken to measure the level of bilirubin and to determine the blood group of neonates and venous blood samples were taken on the third day after birth. Data analysis was performed by using descriptive and statistical analysis(P<0.05).

The mean levels of total and direct bilirubin of neonates in birthday and third day were 2.8 ±1.00 and 0.31±0.10 and 13.13±2.53 and 0.29±0.14 mg/dl, respectively. In addition, cord albumin was also reported to be 3.2±0.64. The mean level of total bilirubin at birth and third day was not significantly different between boys and girls (p.value=0.92). There was a significant and direct correlation between maternal age and total cord blood bilirubin level (p.value=0.04), and also total bilirubin level at the third day of birth had a significant and direct correlation with the number of abortions (p.value=0.05). Moreover, the level of total bilirubin and third day of birth were inverse correlated with albumin level.

High risk neonates need more accurate follow-up for jaundice, because timely diagnosis and very simple treatment can reduce the potential risks of neonatal jaundice. The present study showed that cord total bilirubin levels compared with bilirubin three days after birth can be used as a suitable diagnostic method to accurately track neonates at risk of jaundice.