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Abstract
Objectives
To assess whether arterial umbilical cord bilirubin (aUCB) level at delivery predicts predischarge neonatal hyperbilirubinemia, facilitating a safe discharge from the hospital.
Methods
Prospective analysis of hospital biochemistry records identified near term and term infants with recorded aUCB and predischarge, at 36 h of life, capillary heal bilirubin (cHB), to identify those with a cutoff of bilirubin levels >9 mg/ml, >75th percentile on the nomogram of Bhutani et al.
Results
Of 616 study neonates, median (IQR) aUCB and cHB levels were 1.5 mg % (IQR 0.7–2.2) and 7.7 mg % (IQR 6.6–8.9), respectively. The values resulted statistically correlated (Pearson correlation coefficient 0.26, p < .0001) and an increment of 1 mg/dl in aUCB was associated with an increment (Regression coefficient, 95% confidence interval) of mean cHB 0.49 (0.33–0.65, p < .0001). Among these, 143 (23.2%) neonates developed bilirubin levels >9 mg/ml at 36 h of life and multivariable analysis confirmed that cHB levels (OR 1.49, 95% CI 1.22–1.82; p < .0001) and vaginal delivery (OR 2.34, 95% CI 1.33–4.36; p = .005) were significantly associated with bilirubin levels >9 mg/ml.
Conclusions
These data suggest that aUCB should be added to the list of major risk factors for neonatal hyperbilirubinemia.
Disclosure statement
No potential conflict of interest was reported by the authors.