Study of Cord Blood Levels of Erythropoietin, Bilirubin and Reticulocyte Count as Early Predictors of Neonatal Hyperbilirubinemia
Background: Neonatal hyperbilirubinemia is a serious neonatal problem which had hazardous effect in the neonates when the level of indirect bilirubin is increased to the levels that could cause kernicterus. Aims: The aim of this research is to study the cord blood levels of erythropoietin (EPO), bilirubin and reticulocyte count (RC) as early predictors of neonatal hyperbilirubinemia. Methods: A prospective case control study, which was done at Tanta University Hospital (TUH) from July 2016 to March 2018 on 90 neonates. The studied neonates were divided into 2 groups: Group 1 (45 neonates) who developed pathological hyperbilirubinemia and required treatment and group 2(45 neonates) who did not develop pathological hyperbilirubinemia and did not require treatment. Cord blood levels of EPO, bilirubin and RC were measured in all the studied neonates in both groups. Recommendation: There was significant difference between both groups as regard cord blood bilirubin (CBB), hemoglobin, EPO & RC levels where the P. value is 0.001*,0.027, *0.001*&0.001*respectively. There was significant positive correlation between cord Blood EPO levels and both CBB & cord blood RC with r=0.610 & 0.579 respectively and P. value is 0.001* & 0.001* respectively. As regard to ROC curve ,There was superiority of cord blood EPO levels where the cut off value was 22.5 mIU/ml while the sensitivity & specificity were 96 & 89 respectively then the cord blood RC where the cut off value was 5.7% while the sensitivity & specificity were 93 & 85 respectively and lastly CBB where the cut off value was 1.8 mg/dl while the sensitivity & specificity were 89 & 78 respectively. Conclusion: Cord blood levels of EPO, bilirubin and RC were increased in cases of pathological neonatal hyperbilirubinemia.