Can bilirubin/albumin ratio predict neurodevelopmental outcome in severe neonatal hyperbilirubinemia? A 3-month follow up study

Abstract Background The risk of kernicterus and BIND may be in part determined by total serum bilirubin (TSB) the level non-albumin bound free bilirubin, which can easily pass blood–brain barrier. Free (Bf) seems a more reliable predictor for neurotoxicity. Bilirubin/albumin ratio (B/A) is considered surrogate parameter Bf has been useful than TSB. aim study to determine whether B/A correlates with newborns severe hyperbilirubinemia if it predict poor neurologic outcome at 3 months follow up. Results This prospective included one hundred seventeen outborn neonates ≥ 35 weeks admitted tertiary care neonatal intensive unit, between May December 2012, TSB 20 mg/dl or necessitating exchange transfusion. Total albumin were done on admission bilirubin/albumin was calculated. score At age months, 112 followed up detailed neurological assessment. Babies who depicted any abnormal motor examination subjected brain stem auditory evoked response MRI examination. Seven infants (6.2%) presented scores admission, mean TSB, significantly higher kernicteric compared those having normal ( P 0.001). lowest occurred our 31 mg/dl. Receiver operation characteristics analysis identified cut off value predicting 9.6 sensitivity 100% specificity 91.4%, whereas 30 showed 83%. Conclusion strong indicator kernicterus. specific should used early management hyperbilirubinemia.