Umbilical cord bilirubin level and pre-discharge hyperbilirubinemia risk. (3rd April 2021)

• Record Type: Journal Article
• Authors: Zanardo, Vincenzo; Simbi, Alphonse K.; Parotto, Matteo; Guerrini, Pietro; Severino, Lorenzo; Ferro, Sergio; Straface, Gianluca
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 34:Number 7(2021)
• Page Start: 1120
• Page End: 1126
• Publication Date: 2021-04-03
• Subjects: Early discharge -- hyperbilirubinemia predictivity -- newborn -- umbilical cord bilirubin -- bilirubin nomogram; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2019.1627318
• Languages: English
• ISSNs: 1476-7058

Abstract

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.