Publication:

Exploring bilirubin/albumin ratio as predictor of significant hyperbilirubinemia among neonate in Southwest Nigeria

Background The concept of prediction of neonatal hyperbilirubinemia offers an attractive option in identifying babies at risk of significant hyperbilirubinemia. This study determined the ability of the cord bilirubin/albumin ratio to predict significant hyperbilirubinemia.

Methods This was a hospital-based longitudinal cross-sectional study conducted on four hundred and seventy-one neonates in a southwest community in Nigeria. Blood samples were obtained for cord bilirubin, cord albumin and cord bilirubin/albumin ratio were analyzed for their predictive ability of significant hyperbilirubinemia at 72-96 hours with follow-up. Receiver observation curve analysis (ROC) was employed to compare the predictive abilities of cord bilirubin, cord albumin and cord bilirubin/albumin ratio.

Results The prevalence of significant hyperbilirubinemia was 4.2%. Cord bilirubin and cord bilirubin/albumin ratio were found to have a significant relationship with the development of significant hyperbilirubinemia at 48-72 hours follow-up. Cord bilirubin of greater than 1.58 mg/dl was shown to be predictive of significant hyperbilirubinemia with a sensitivity, specificity, negative predictive value, and positive predictive value of 70%, 48.34%, 5.7% and 97.3% respectively.

Conclusions Comparing the predictive abilities of cord bilirubin, cord albumin and cord bilirubin/albumin ratio; the study reveals that cord bilirubin has the best ability to predict significant hyperbilirubinemia.