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A study on bilirubin / albumin ratio in prediction of bilirubin induced neural dysfunction in neonatal hyperbilirubinemia

Authors:Ekta Patel, GG Potey
Int J Biol Med Res. 2014; 5(4): 4554-4555  |  PDF File

Abstract

INTRODUCTION: Physiological jaundice of the newborn (unconjugated hyperbilirubinemia) develops in first week of life in 60% of full term and 80% of pre-term neonates and can cause BIND. Its pathogenesis is multi factorial and interaction between different bilirubin fractions plays a role. AIMS AND OBJECTIVES: To evaluate the B/A (mg/g) ratio in comparison with neonatal bilirubin for predicting acute BIND in term and preterm neonatal hyperbilirubinemia before therapy. MATERIALS AND METHODS: The birth weight, gestational age and general health of neonates were noted. Neonates were observed and examined clinically for development of acute BIND until discharge. Neonatal bilirubin, unconjugated bilirubin, conjugated bilirubin and albumin levels were estimated in serum prior to therapy. All analysis was done on Vitros-250 auto analyzer. RESULT: The study comprised of 30 preterm and 25 term neonates. 44% of full term and 80% of preterm neonates developed reversible BIND with average B/A ratio of 6.34 and 5.78 respectively. The B/A ratio are in range of >5.3 and <7.0 for both the group, which is associated with reversible abnormalities of auditory brainstem responses. Neonatal bilirubin and B/A ratio were significantly higher in patients with BIND (p<0.05). Preterm neonates are more prone to develop BIND than full term neonates (p<0.05). CONCLUSION: Using B/A ratio in conjunction with total neonatal bilirubin can improve the accuracy of prediction of BIND and management of hyperbilirubinemia.