scholarly journals Bilirubin dosage in cord blood: could it predict neonatal hyperbilirubinemia?

2004 ◽  
Vol 122 (3) ◽  
pp. 99-103 ◽  
Author(s):  
Adélia Jeha Nasser Bernaldo ◽  
Conceição Aparecida de Mattos Segre
Keyword(s):  
Cord Blood ◽  
Blood Group ◽  
Serum Levels ◽  
Full Term ◽  
Neonatal Hyperbilirubinemia ◽  
Cutoff Point ◽  
Unconjugated Bilirubin ◽  
Significant Variable ◽  
The Third ◽  
Term Newborns

CONTEXT: With early discharge, many newborns have to be readmitted to hospital for hyperbilirubinemia to be treated, and this has been held responsible for the reappearance of kernicterus. OBJECTIVE: To evaluate whether bilirubin levels in cord blood could predict neonatal hyperbilirubinemia that would require treatment, in full-term newborns up to their third day of life. TYPE OF STUDY: Prospective study. SETTING: Neonatal Unit of Hospital Israelita Albert Einstein, São Paulo, Brazil. PARTICIPANTS: 380 full-term newborns considered normal: with or without ABO/Rh blood group incompatibility and without other complications. PROCEDURES: Blood was taken from the umbilical cord for analysis of conjugated, unconjugated and total bilirubin serum levels. The newborns were followed up until discharge, and unconjugated bilirubin that required phototherapy was compared to the cord bilirubin assay. Discriminant analysis was used to classify newborns: with or without risk of needing phototherapy by the third day of life. MAIN MEASUREMENTS: Bilirubin assay in cord blood; mother's and newborn's blood groups; phototherapy indication. RESULTS: The mean value for unconjugated bilirubin in cord blood was significantly higher in newborns whose unconjugated bilirubin required phototherapy. The presence of ABO blood group incompatibility was a significant variable in relation to unconjugated bilirubin that required phototherapy. The most useful cutoff point for unconjugated bilirubin in cord blood was 2.0 mg/100 ml. DISCUSSION: Cord blood could be collected, stored and used for further analysis of unconjugated bilirubin levels as a means for considering whether or not to discharge a moderately jaundiced child from hospital, in association with other resources. CONCLUSIONS: Blood incompatibility between mother and child was a predictor for the appearance of hyperbilirubinemia that required treatment. Considering a cutoff point of 2.0 mg/100 ml, it could be concluded that 53% of the newborns who had greater unconjugated bilirubin levels in cord blood would reach levels requiring phototherapy by the third day of life.

scholarly journals Correlation between cord blood bilirubin level and incidence of hyperbilirubinemia in term newborns

2009 ◽  
Vol 49 (6) ◽  
pp. 349 ◽  
Author(s):  
Rudy Satrya ◽  
Sjarif Hidayat Effendi ◽  
Dida Akhmad Gumida
Keyword(s):  
Observational Study ◽  
Cord Blood ◽  
Blood Group ◽  
Bilirubin Level ◽  
Prospective Observational Study ◽  
High Sensitivity ◽  
Unconjugated Bilirubin ◽  
Group Test ◽  
Term Newborns ◽  
Conjugated Bilirubin

Background Discharging healthy term newborns from thehospital after delivery at increasingly earlier postnatal ages hasrecently become a common practice due to medical, social, andeconomic reasons, however it contributes to readmission becauseof jaundice.Objective To investigate the correlation between level of cordblood bilirubin and development of hyperbilirubinemia amonghealthy term newborns.Methods Prospective observational study was performed on88 healthy term newborns. Cord blood was collected for thetotal bilirubin, conjugated bilirubin, unconjugated bilirubinlevel measurement and blood group test. Measurements of totalbilirubin, conjugated bilirubin, and unconjugated bilirubin wererepeated on the 5th day with serum sampling, or as soon as thenewborn appeared to be jaundice.Results Subjects were categorized into hyperbilirubinemia andnon-hyperbilirubinemia newborns. There was a correlationbetween cord blood and the 5th day bilirubin level. By ROCanalysis, cord blood bilirubin level of 2:2.54 md/dL was determined to have high sensitivity (90.5%), specificity of 85%, and accuracy of 86.4%.Conclusions There is a correlation between cord blood bilirubinlevel and hyperbilirubinemia in healthy term newborns. Cordblood bilirubin level at or greater than 2.54 mg/dL can predictthe development of hyperbilirubinemia.

scholarly journals Optimization of Hypoxic Brain Injuries Diagnostics in Full-Term Newborns

2021 ◽  
Vol 6 (2) ◽  
pp. 133-141
Author(s):  
M. S. Panova ◽  
A. S. Panchenko ◽  
V. A. Mudrov
Keyword(s):  
Cord Blood ◽  
Brain Damage ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Full Term ◽  
Damage Diagnosis ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain ◽  
Tnf Α ◽  
Term Newborns

The problem of early diagnosis of the central nervous system damage in newborn before the onset of clinical symptoms remains relevant at the present time.The aim of the study was to optimize the hypoxic brain damage diagnosis in full-term newborns by analyzing the concentration of cytokines in the umbilical cord blood.Materials and methods. During the first stage of the study, a prospective analysis of concentrations of interleukins (IL-1β, IL-4, IL-6, IL-8, IL-10), TNF-α and neuron-specific enolase (NSE) in the umbilical cord blood serum of full-term newborns was performed. The second stage of the study included the retrospective analysis of clinical data and instrumental research methods. The main method for diagnosing in the development of hypoxic brain damage in newborns was neurosonography.Results. The development of hypoxic brain damage is evidenced by the concentration of IL-1β over 30.3 pg/ml, IL-4 – over 1.7 pg/ml, IL-6 – over 79.4 pg/ml, IL-8 – over 107.7 pg/ml, NSE – more than 10.3 ng/ml and TNF-α – more than 1.6 pg/ml in umbilical cord blood.Conclusion. The results of the study confirmed that the comprehensive assessment of the cytokines concentration in the umbilical cord blood improves the hypoxic brain damage diagnosis in newborns. Analysis of the level of these markers immediately after the birth will optimize the management tactics of newborns who have undergone hypoxic exposure in antenatal and intranatal period. 

scholarly journals Effect of phototherapy on serum calcium level in term newborns

2017 ◽  
Vol 4 (6) ◽  
pp. 1975
Author(s):  
Cyril Ignatious Rozario ◽  
Preethi S. Pillai ◽  
Ranamol T.
Keyword(s):  
Birth Weight ◽  
Blood Group ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Neonatal Hyperbilirubinemia ◽  
Preterm Neonates ◽  
P Value ◽  
Term Neonates ◽  
Term Newborns

Background: Hyperbilirubinemia is one of the most prevalent problems in neonates. Jaundice is observed during first week of life in approximately 60% of term neonates and 80 % of preterm neonates. Phototherapy is one of the routine methods for management of hyperbilirubinemia. The aim of this study is to assess the effect of phototherapy on serum calcium level in term newborns with neonatal hyperbilirubinemia who undergo phototherapy and to find out the association between effect of phototherapy on serum calcium level and birth weight, postnatalage, type of feeding and blood group incompatibility.Methods: 100 newborns with neonatal hyperbilirubinemia admitted in newborn nursery were selected for the study. Serum calcium estimation was done before phototherapy. All newborns were subjected to double surface phototherapy. After 48 hours of phototherapy serum calcium was estimated and compared with earlier value.Results: Out of 100 newborns studied 67 babies had a decrease in serum calcium level after 48 hrs of phototherapy. And this reduction in calcium level was found to be statistically significant (p value <0.001). Only 3 babies developed hypocalcemia (serum calcium <7 mg/dl). None of them were symptomatic. There was no significant association between reduction in serum calcium level and birth weight, postnatalage, type of feeding and blood group incompatability.Conclusions: There is signiticant reduction in serum calcium level after phototherapy but risk of hypocalcemia is low in healthy full-term neonates. No significant association was found between reduction in serum calcium level and birth weight, postnatal age,type of feed, and blood group incompatibility.

scholarly journals Study of Correlation of Cord Blood Bilirubin with Neonatal Hyperbilirubinemia

2016 ◽  
Vol 3 (1) ◽  
pp. 60 ◽  
Author(s):  
Nilesh Ahire ◽  
Ravindra Sonawane ◽  
Rajendra Gaikwad ◽  
Suhas Patil ◽  
Tushar Sonawane
Keyword(s):  
Cord Blood ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Early Discharge ◽  
Neonatal Hyperbilirubinemia ◽  
Research Centre ◽  
Preterm Neonates ◽  
College Hospital ◽  
Term Newborns

<strong>Introduction</strong>: Neonatal Hyperbilirubinemia (NH) is a universal problem affecting nearly 60% of term and 80% of preterm neonates during first week of life. Early discharge of healthy term newborns is a common practice because of medical, social and economic constraints. Insignificant number (6.5%) of babies, NH is a cause for readmission. The present study was conducted to correlate the Cord Blood Bilirubin (CBB) level with subsequent NH. <strong>Methods:</strong> Study was performed at the Department of Pediatrics in a Medical College Hospital and Research Centre. Intramurally delivered, 113 Healthy full-term newborns during 1-year period were prospectively enrolled. CBB was estimated. Serum Bilirubin estimation was done at 48 hours and 5 day of age and later if required. <strong>Results:</strong> Significant NH in our study is 3.5%. Mean total bilirubin on second postnatal day was 10.58 mg/dl and on fifth post natal day was 10.81 mg/dl. Using CBB level of ≥3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 98.17%, positive predictive value of 66.67% and negative predictive value of 100%. <strong>Conclusion:</strong> A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤3mg/dl) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥3mg/dl should be followed more frequently.

scholarly journals Prediction of significant hyperbilirubinemia by estimating cord blood bilirubin in neonates with ABO incompatibility

2019 ◽  
Vol 6 (2) ◽  
pp. 670
Author(s):  
Ruchika Singh ◽  
Hemant Jain
Keyword(s):  
Cord Blood ◽  
Blood Group ◽  
Roc Curve ◽  
Total Bilirubin ◽  
Proper Time ◽  
Neonatal Hyperbilirubinemia ◽  
P Value ◽  
Roc Curve Analysis ◽  
Maximum Serum ◽  
Abo Incompatibility

Background: Neonatal hyperbilirubinemia is a common condition that may occur in 60-70 % of term babies and the most common pathological cause leading to hyperbilirubinemia is ABO incompatibility. ABO incompatible newborns are reported to be at greater risk of significant hyperbilirubinemia and are associated with significant morbidity like development of kernicterus.  So early intervention, at proper time, is mandatory to prevent this sequel.Methods: A prospective study included 240 term new-borns with gestational age of >37 weeks and birth weight >2.5 kg born to ‘O’ blood group mothers. Soon after delivery, cord blood was sent for blood group, total bilirubin and direct coombs test. All enrolled new-borns were assessed clinically daily till day 5th for appearance of hyperbilirubinemia using Kramer method. The data was analysed using descriptive analysis, ROC curve in SPSS version 14.Results: Among two hundred forty ABO incompatible newborns, 40 (17%) had developed hyperbilirubinemia and among them most common blood group associated was B+ve (75%). Association between cord bilirubin content and maximum serum bilirubin content among newborn who developed hyperbilirubinemia was found to be significant (P value <0.01). As per ROC curve analysis, cord blood total bilirubin cut off value of 1.79mg/dl had sensitivity (82.5%), specificity (55.5 %), PPV (27.04%) and NPV (94.06).Conclusions: Cord blood total bilirubin levels ≥1.79mg/dl has a good predictive ability for prediction of significant hyperbilirubinemia among ABO incompatible new-born. DCT is neither specific nor sensitive screening tool for development of Neonatal hyperbilirubinemia in ABO incompatibility.

scholarly journals Levels of sex steroid hormones and their receptors in women with preeclampsia

2020 ◽  
Author(s):  
Kuo-Chung Lan(Former Corresponding Author) ◽  
Yun-Ju Lai ◽  
Hsin-Hsin Cheng ◽  
Ni-Chin Tsai ◽  
Yu-Ting Su ◽  
...  
Keyword(s):  
Cord Blood ◽  
Steroid Hormones ◽  
Steroid Receptors ◽  
Serum Levels ◽  
High Serum ◽  
Sex Steroid Hormones ◽  
Sex Steroid ◽  
Mrna Levels ◽  
Third Trimester ◽  
The Third

Abstract Background: Pregnant women have high serum concentrations of sex steroid hormones, which are major regulators of paracrine and autocrine responses for many maternal and placental functions. The main purpose of this study was to compare patients with preeclampsia and patients with uncomplicated pregnancies in terms of serum steroid hormones (estradiol [E2], progesterone [P4], dehydroepiandrosterone sulfate [DHEAS], and testosterone [T]) throughout pregnancy and the levels of cord blood and placental steroid receptors during the third trimester. Methods: Quantitative real-time reverse transcription PCR, western blotting, and immunohistochemistry were used to determine the levels of steroid hormones in the serum and cord blood and the placental levels of estrogen receptor-α (ERα), ERβ, androgen receptor (AR), and progesterone receptor (PR). Results: There were 45 women in the uncomplicated pregnancy group and 30 women in the preeclampsia group. Serum levels of T were greater and serum levels of E2 were reduced in the preeclampsia group, but the two groups had similar levels of P4 and DHEAS during the third trimester. Cord blood had a decreased level of DHEAS in the preeclampsia group, but the two groups had similar levels of P4, E2, and T. The two groups had similar placental mRNA levels of ERα, ERβ, AR, and PR, but the preeclampsia group had a higher level of ERβ protein and a lower level of ERα protein. Immunohistochemistry indicated that the preeclampsia group had a greater level of ERβ in the nucleus and cytoplasm of syncytiotrophoblasts and stromal cells. Conclusions: Women with preeclampsia had lower levels of steroid hormones, estrogen, and ERα but higher levels of T and ERβ. These molecules may have roles in the pathogenesis of preeclampsia.

scholarly journals Prediction of neonatal hyperbilirubinemia using umbilical cord blood bilirubin

2019 ◽  
Vol 6 (2) ◽  
pp. 248
Author(s):  
Kiran Haridas ◽  
Rajendra Shinde ◽  
Gangadhar Belavadi
Keyword(s):  
Early Detection ◽  
Prospective Study ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Clinical Assessment ◽  
Neonatal Period ◽  
Neonatal Hyperbilirubinemia ◽  
Potential Complication ◽  
Term Newborns

Background: Neonatal hyperbilirubinemia is a common problem among newborns.  Neonatal hyperbilirubinemia has a potential complication of kernicterus which is still seen in many newborns. In present study authors used umbilical cord blood bilirubin to predict the development of significant hyperbilirubinemia in the early neonatal period. The objective of this study is to evaluate the correlation between concentration of bilirubin in the cord blood and occurrence of hyperbilirubinemia in term newborns.Methods: In this prospective study authors included 500 term healthy consecutively born babies whose umbilical cord blood was collected and were followed up for first 7 days for the appearance of jaundice. The clinical assessment of jaundice was done by Kramer rule. The data was analyzed by using SPSS 17 statistical software.Results: Study found that umbilical cord blood bilirubin was 90% sensitive and 87% specific with a PPV of 75% and NPV of 92% in predicting significant neonatal hyperbilirubinemia.Conclusions: The study conducted clearly points that the use of cord blood bilirubin for identifying newborns at risk of hyperbilirubinemia helps in early detection and treatment of jaundice. There by preventing the potential complication kernicterus. This method is economical and socially acceptable. Hence cord blood bilirubin should be done on all healthy term newborns.

scholarly journals Cord Blood Levels of Angiopoietin-Like 7 (ANGPTL7) in Preterm Infants

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Xin Xia ◽  
Zhuxiao Ren ◽  
Longli Yan ◽  
Xuaner Zheng ◽  
Haoming Yang ◽  
...  
Keyword(s):  
Cord Blood ◽  
Preterm Infants ◽  
Gestational Age ◽  
Underlying Mechanism ◽  
Full Term ◽  
Enzyme Linked Immunosorbent Assay ◽  
Blood Levels ◽  
The Third ◽  
Multiple Line ◽  
Assay Result

Objective. ANGPTL7 is a member of the angiogenin-like protein family. Compared to other members, ANGPTL7 is the least known. Recent studies have explored the relationship between ANGPTL7 and multiple pathological processes and diseases. However, there is no research about ANGPTL7 in neonates. This study was designed to investigate the concentration of ANGPTL7 in cord blood of preterm infants. Method. Singleton infants born in November 2017 to June 2019 in the study hospital were enrolled in the study. Maternal and neonatal clinical data were collected. ANGPTL7 levels in cord blood and serum on the third day after birth were measured by an enzyme-linked immunosorbent assay. Result. A total of 182 infants were enrolled in this study. Patients were categorized into two groups by gestational age (102 preterm, 80 full-term). ANGPTL7 levels in preterm infants were significantly higher than that in full-term babies ( t = 15.4 , P < 0.001 ). In multiple line regression analysis, ANGPTL7 levels independently correlated with gestational age ( β = − 0.556 , P < 0.001 ). There is also no correlation between preterm outcomes and ANGPTL7 levels. Cord blood levels of ANGPTL7 were significantly higher than those in serum on the third day after birth ( t = 13.88 , P < 0.001 ). Conclusion. Cord blood ANGPTL7 levels are higher in preterm infants than full-term babies. The levels are independently influenced by gestational ages and attenuated significantly after birth. The underlying mechanism needs to be further studied.

Sign in / Sign up

Export Citation Format

Share Document