Predictive Value of Cord Blood Albumin For Neonatal Hyperbilirubinemia in Term Newborns: A Prospective Study

Abstract

Aim: This study aimed to evaluate the predictive value of cord blood albumin (CBA) levels in assessing the risk of neonatal hyper-bilirubinemia (NNH) in term newborns and determine an optimal CBA threshold for phototherapy (PT) prediction. Introduction: Neonatal jaundice affects 60% of term and 80% of preterm infants. Severe cases need timely intervention to prevent kernicterus. Early discharge increases undiagnosed jaundice risk, especially in low-resource settings. CBA - Cord blood Albumin is a potential biomarker for identifying high-risk newborns, enabling early intervention and follow-up planning. Methods: This prospective observational study was conducted at Jagannath Gupta Institute of Medical Sciences and Hospital, Kolkata, over 18 months (July 2022 - December 2023). Eighty term newborns meeting inclusion criteria were enrolled. CBA levels were measured at birth, and total serum bilirubin (TSB) was assessed at 72 hours. The requirement for phototherapy was determined using AAP guidelines. Statistical analyses were conducted using SPSS version 26. Results: Of the 80 newborns, 13 (16.25%) developed significant jaundice, requiring phototherapy but not exchange transfusion. Newborns were
categorized by CBA levels: ≤2.8 g/dL (81. 8% developed jaundice), 2.9–3.3 g/dL (9.3% developed jaundice), and ≥3.4 g/dL (0% developed jaundice). A significant negative correlation (r = -0.41, p < 0.00001) was found between CBA and TSB levels, confirming that lower CBA levels were associated with higher bilirubin levels. Conclusion: CBA ≤2.8 g/dL strongly predicts neonatal jaundice, while CBA ≥3.4 g/dL is protective. CBA measurement at birth serves as a low-cost screening tool for identifying newborns at risk, guiding early discharge and follow-up decisions. Larger studies are needed to establish standardized CBA thresholds for routine screening.