Is Umbilical Cord Blood Bilirubin a Reliable Predictor of Newborn Hyperbilirubinemia?

Neonatal hyperbilirubinemia is the prevailing condition in newborns during the first week of life. Diagnosing substantial hyperbilirubinemia and initiating timely therapy in infants has become challenging due to early release following delivery. Therefore, there is a need to anticipate which newborns are at a high risk of developing hyperbilirubinemia. The motivation behind this study was to investigate whether the bilirubin level in the umbilical cord blood of neonates at birth could serve as a reliable indicator for predicting neonatal hyperbilirubinemia that would require phototherapy. This study utilized a cross-sectional design and included a sample of 208 babies who were healthy and born at full term (gestational age >37 weeks). The newborns were delivered in several hospitals located in Rajahmundry, Andhra Pradesh, India. The colorimetric Diazo technique was used to measure umbilical cord bilirubin (UCB). Hyperbilirubinemia was characterized by bilirubin levels that exceeded the recommended threshold for phototherapy, as outlined in the NICE guidelines. The mean umbilical cord blood (UCB) concentration in the newborns was 1.65±0.75 mg/dL. Approximately 39% of newborns necessitated phototherapy. The cutoff limit of UCB for identifying newborn hyperbilirubinemia was 1.975 mg/dL with an excellent sensitivity (76.54%) and specificity (87.4%). The receiver operating characteristic (ROC) curve demonstrated a high area under the curve (AUC) value of 0.879 for UCB in accurately identifying neonatal hyperbilirubinemia. The Youden measure demonstrated a satisfactory level of fairness in the current investigation. The prediction accuracy of the cutoff point of present study was likewise high. The findings of the current investigation demonstrated that the UCB is an excellent predictor of newborn hyperbilirubinemia and early identification of jaundice.