The Value of Umbilical Cord Blood Bilirubin Measurement in Predicting the Development of Significant Hyperbilirubinemia in Healthy Newborn

The present study was conducted to investigate the predictability of early serumbilirubin levels on the subsequent development of neonatal hyperbilirubinemia. Forthis purpose 84 healthy newborn infants were enrolled and followed up for first 5 daysof life. Study subjects were divided into two groups. Group-I consisted of 71 subjects,who did not develop significant hyperbilirubinemia (bilirubin <17mg/dl); Group-IIconsisted of 13 newborns, who developed significant hyperbilirubinemia (bilirubin >17mg/dl) during the follow up. Of the enrolled subjects, 46 (55%) were male and rest 38(45%) were female; 64 (76%) were term babies and 20 (24%) were pre-term babies.Significantly higher percentage of pre-term babies developed hyperbilirubinemia. ROC(receiver operating characteristic) analysis demonstrates that the critical value ofcord blood bilirubin >2.5mg/dl had the high sensitivity (77%) and specificity (98.6%)to predict the newborn who would develop significant hyperbilirubinemia. At this levelthe negative predictive value was 96% and positive predictive value 91%. In oursetting infants having umbilical cord blood total serum bilirubin (TSB) >2.5 mg/dlshould be followed up strictly either in hospital or as an outpatient department on day5 if practicable. Infants having TSB <2.5mg/dl in cord blood can be discharged early.Key words: Umbilical cord bilirubin; neonatal jaundice; healthy newborn.DOI: 10.3329/bjch.v33i2.5677Bangladesh Journal of Child Health 2009; Vol.33(2): 50-54

Download Full-text

Oxygen Consumption in Platelets of Newborn Infants before and after Stimulation by Thrombin.

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647969 ◽

1976 ◽

Vol 35 (03) ◽

pp. 712-716 ◽

Cited By ~ 3

Author(s):

D. Del Principe ◽

G Mancuso ◽

A Menichelli ◽

G Maretto ◽

G Sabetta

Keyword(s):

Oxygen Consumption ◽

Cord Blood ◽

Umbilical Cord ◽

Newborn Infant ◽

Umbilical Cord Blood ◽

Newborn Infants ◽

O2 Consumption ◽

Adult Control ◽

Healthy Newborn ◽

Before And After

SummaryThe authors compared the oxygen consumption in platelets from the umbilical cord blood of 36 healthy newborn infants with that of 27 adult subjects, before and after thrombin addition (1.67 U/ml). Oxygen consumption at rest was 6 mμmol/109/min in adult control platelets and 5.26 in newborn infants. The burst in oxygen consumption after thrombin addition was 26.30 mμmol/109/min in adults and 24.90 in infants. Dinitrophenol did not inhibit the burst of O2 consumption in platelets in 8 out of 10 newborn infants, while the same concentration caused a decrease in 9 out of 10 adult subjects. Deoxyglucose inhibited the burst in O2 consumption in newborn infant and adult platelets by about 50%. KCN at the concentration of 10−4 M completely inhibited basal oxygen consumption but did not completely inhibit the burst after thrombin. At the concentration of 10−3 M, it inhibited both basal O2 consumption and the burst in infants and adult subjects.

Download Full-text

A STUDY OF UMBILICAL CORD BILIRUBIN AS A PREDICTOR OF SIGNIFICANT NEONATAL JAUNDICE IN A TERTIARY RURAL CARE HOSPITAL

10.36106/ijsr/8433532 ◽

2020 ◽

pp. 83-86

Author(s):

Rohan Yadav ◽

P. Sunil Kumar ◽

Mahendrappa K.B. ◽

G.M. Kumar ◽

Channabasavanna N.

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Predictive Value ◽

Neonatal Jaundice ◽

Serum Bilirubin ◽

Total Serum ◽

Care Hospital ◽

Term Infants ◽

Increased Risk

Introduction. Around 80 percent of preterm infants and 60 percent of term infants are affected by neonatal jaundice in the first week of life. Early discharge of healthy term infants is a common practice because of economic constraints and social reasons. Which new-borns are at increased risk for developing significant hyperbilirubinemia (Total serum bilirubin ≥ 15mg/dl) is difficult to predict. This study was taken up to evaluate the predictive value of cord blood bilirubin level for identifying term infants for subsequent hyperbilirubinemia. Material and methods. This prospective observational study was conducted in Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka from 1st of April 2020 to 30th September 2020. 100 healthy term babies satisfying the eligibility criteria and born in the study period were included in the study. Umbilical cord blood was collected and was correlated with serum bilirubin levels at 48hours of life. Significant hyperbilirubinemia was taken as ≥ 15mg/dl at 48 hrs of life. Results. The incidence of neonatal hyperbilirubinemia was 14%. By using umbilical cord blood bilirubin ≥ 3mg/dl, significant hyperbilirubinemia can be predicted with Sensitivity of 92.9%, Specificity of 96.5%, Positive Predictive Value of 81.3% and Negative Predictive Value of 98.8%. Conclusion. Umbilical cord blood bilirubin ≥ 3mg/dl in healthy term babies can help in prediction of significant jaundice and thus can help in identifying high risk new-borns so that these neonates can be followed up more closely, it can also help in identifying neonates who are not at increased risk of developing significant jaundice, hence can prevent unnecessary hospital stay.

Download Full-text

FREE RADICAL-RELATED DISEASES: THE PREDICTIVE VALUE OF BIOMARKERS IN THE UMBILICAL CORD BLOOD

Journal of the Siena Academy of Sciences ◽

10.4081/jsas.2013.49 ◽

2013 ◽

Vol 5 (1) ◽

pp. 49

Author(s):

S. Perrone ◽

M.G. Alagna ◽

M.S. Cori ◽

A. Santacroce ◽

S. Negro ◽

...

Keyword(s):

Free Radical ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Predictive Value

Download Full-text

Predictive value of umbilical cord blood bilirubin in neonatal hyperbilirubinemia

Egyptian Pediatric Association Gazette ◽

10.1016/j.epag.2013.04.006 ◽

2013 ◽

Vol 61 (1) ◽

pp. 23-30 ◽

Cited By ~ 6

Author(s):

AlaaEldin A. Zeitoun ◽

Hala F. Elhagrasy ◽

Doaa M. Abdelsatar

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Predictive Value ◽

Neonatal Hyperbilirubinemia

Download Full-text

Apolipoprotein A-1 in Umbilical Cord Blood of Newborn Infants: Relation to Gestational Age and High-Density Lipoprotein Cholesterol

Pediatric Research ◽

10.1203/00006450-198804000-00002 ◽

1988 ◽

Vol 23 (4) ◽

pp. 348-351 ◽

Cited By ~ 13

Author(s):

C Richard Parker ◽

Stephen J Fortunato ◽

Bruce R Carr ◽

John Owen ◽

Gary D V Hankins ◽

...

Keyword(s):

High Density Lipoprotein ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Gestational Age ◽

High Density Lipoprotein Cholesterol ◽

Newborn Infants ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Apolipoprotein A

Download Full-text

The Predictive Value of the Hematopoietic Cell Transplantation (HCT)-Specific Comorbidity Index (CI) in Recipients of Umbilical Cord Blood (UCB) Transplantation.

Blood ◽

10.1182/blood.v110.11.5065.5065 ◽

2007 ◽

Vol 110 (11) ◽

pp. 5065-5065

Author(s):

Claudio G. Brunstein ◽

Navneet Majhail ◽

Daniela C. Setubal ◽

Todd E. DeFor ◽

Jeffrey S. Miller ◽

...

Keyword(s):

Cord Blood ◽

Cell Transplantation ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Predictive Value ◽

Acute Gvhd ◽

Hematopoietic Cell Transplantation ◽

Disease Risk ◽

Conditioning Regimens ◽

Comorbidity Index

Abstract The hematopoietic cell transplantation (HCT)-specific comorbidity index (CI) has been shown to predict nonrelapse mortality (NRM) and overall survival (OS) after sibling and unrelated adult volunteer donor transplantation (Sorror Blood 2005, 106:2912). We retrospectively studied the predictive value of the HCT-CI in a cohort of 182 patients who underwent an umbilical cord blood (UCB) transplant for advanced or high risk malignancy at the University of Minnesota, between August 2001 and May 2006. Patients receive either a myeloablative (MA, n=54) or nonmyeloablative (NST, n=128) conditioning regimens followed by cyclosporine and mycophenolate mofetil in both groups. Patients received single (n=27) or double (n=155) UCB grafts that were HLA-matched 4–6/6 matched to the recipient, and for double UCB grafts 4–6/6 matched each other as well. All received G-CSF from day 0 to ANC > 2500 for three days. Antibiotic prophylaxis, blood products, and growth factor administration followed the same institutional guidelines. Patients’ median age was 47 (range: 18–69), median weight 78 kg (r: 45–149), and 51% were CMV seropositive. Thirty patients, all in the NST group, had prior autologous transplant. HCT-CI scores were assigned retrospectively; scores were zero (n=18%), 1–2 (n=33%), or >2 (n=49%) and were comparable between the MA and NST groups. The median nucleated cell dose (NCD) was 3.5 X 107/kg (range: 1.1–6.8) and CD34+ cell dose was 4.7 X 105/kg (range: 0.7–18.8) with no difference in recipients of singles and double UCB grafts or MA and NST conditioning regimens. The NRM at 1-year was 13% (95%CI, 2–24) for patients with HCT-CI score of zero, 20% (95%CI, 10–30) for scores 1–2, and 22% (95%CI, 14–30) for score > 2 (p=.46). In multivariate regression model, HCT-CI score was not an independent predictor of NRM [HCT-CI score Zero RR 1(ref), 1–2 RR 1.5 (95%CI, 0.5–4.5, p=.5; >2 RR 1.8 (95%CI, 0.6–5.3), p=.27], whereas patients who received a NST conditioning had significantly lower relative risk (RR) of NRM (RR 0.5, 95%CI, 0.2–1.0, p=.05). The 1-yr OS was 72% (95%CI, 53–84) for patients with score zero, 65% (95%CI, 52–76) for scores 1–2, and 56% (95%CI, 29–65) for scores >2. In Cox regression analysis the HCT-CI was not associated with the risk of death, in contrast to disease risk group, development of grades II–IV acute GVHD, and interval between diagnosis and transplantation (Table). While the HCT-CI was not predictive of either NRM nor OS in recipients of UCBT, high OS for the group as whole, patient numbers and selection procedures may explain, at least in part, these results. However, it is also possible that the HCT-CI scoring system may not yet be optimized and some medical conditions may have greater impact on HSC transplantation outcome as compared to others. Factors RR of Death (95% C.I.) P-value * reference group HCT-Co-Morbidity Score 0* 1.0 1–2 1.4 (0.6–3.1) .40 >2 1.9 (0.9–3.9) .09 Conditioning Myeloablative* 1.0 Nonmyeloablative 0.9 (0.6–1.6) .83 Disease Risk Standard* 1.0 High 3.1 (1.5–6.5) <.01 Acute GVHD Grades 0–I 1.0 Grades II–IV 0.5 (0.3–0.9) <.01 Years from Dx to TX < 1* 1.0 1–2 0.8 (0.4–1.5) .50 >2 0.5 (0.3–0.9) .02

Download Full-text