959 ESTIMATION OF CORD BILIRUBIN AS A MEANS OF SCREENING NEWBORNS AT RISK OF NEONATAL HYPERBILIRUBINEMIA

Abstract

Cord blood bilirubins were determined in 185 term Rh positive infants with uncomplicated intrapartum courses within 12-24 hours of birth by the method of Melloy-Evelyn. Infants with any manifestations of illness in the first four days of life were excluded. Daily physical examinations were performed on all infants but serial bilirubins were determined only in those who were clinically jaundiced. Healthy non-jaundiced infants were discharged on the fourth day of life. The neonatal courses were subsequently evaluated in terms of the development of pathologic jaundice (>5mg/dl/day or > 12mg/dl), and correlated with the cord bilirubin values. The results indicated that during the first four days of life, infants with cord bilirubin values less than 2.0mg/dl had a benign course whereas those with 2.4mg/dl or greater developed pathologic jaundice requiring investigative and therapeutic intervention. This was particularly impressive in infants with levels ≥ 3.Omg/dl because all such infants required exchange transfusion within 24 hours of birth. There was a statistically significant difference (P<0.05) between the mean cord bilirubin of infants who developed pathologic jaundice requiring phototherapy and/or exchange transfusion (2.85), and those that did not (1.31).

These findings suggest that cord bilirubin might be used as a screening tool for pathologic jaundice in the first four days of life, and thereby facilitate early investigative and therapeutic intervention.

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