Background: Jaundice is the commonest abnormal physical finding during first week of life. Over two-thirds of newborn babies develop clinical jaundice and by adult standards, almost all newborn babies are jaundiced. In term babies, physiological jaundice appears between 36-72 hours of age while pathological jaundice appears within 24 hours of life. Serum total bilirubin concentrations have been defined as nonphysiologic if the concentration exceeds 5 mg/dl on the first day of life in a term neonate, 10 mg/dl on the second day, or 12 to 13 mg/dl thereafter.

Objectives: To evaluate the critical cord blood bilirubin level as a predictor of significant hyperbilirubinemia and the occurrence of hyperbilirubinemia in term newborns.

Materials and Methods: In a cross-sectional study conducted over 2 years in a tertiary care referral hospital in Manipur, India, 300 newborns without complications were selected and the cord blood bilirubin estimation was done at birth and serum bilirubin at 48 hours of life.

Results: There were no significant differences between the cases who cord bilirubin level < 3 mg/dl and > 3 mg/dl with respect to various factors that may be associated with the risk of hyperbilirubinemia, such as gender, gestational age, birth weight and oxytocin used. Mean cord bilirubin level was 2.01 mg/dl. Mean total bilirubin on 48-hour post- natal day was 10.06 mg/dl. There was a positive correlation between cord bilirubin and 48-hour postnatal day serum bilirubin. The correlation between cord bilirubin and development of significant jaundice in the first three days is statistically significant.

Conclusions: Using cord bilirubin level of ≥ 3 mg/dl, hyperbilirubinemia can be predicted with sensitivity of 100%, specificity of 99%, positive predictive value of 66% and negative predictive value of 100%.

Keywords: Jaundice, term newborns, serum bilirubin.

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Namganglung Golmei

Assistant Professor, Department of Pediatrics, RIMS, Imphal