title: Does cord blood bilirubin level help the physician in the decision of early postnatal discharge?
abstract: OBJECTIVE
  Early postnatal discharge of newborns leads to the risk of readmission to the hospital, mostly for neonatal hyperbilirubinemia. Increasing the length of hospital stay is not an acceptable solution for medical, social and economic constraints. Hence, predicting the high risk neonates for subsequent hyperbilirubinemia is required. This study was planned to investigate the predictive value of umbilical cord blood bilirubin (CBBil) level for significant neonatal hyperbilirubinemia.
  
  
  METHODS
  Cord blood bilirubin, serum total/direct bilirubin levels and newborn/mother's blood groups were obtained from 350 term neonates. Total/direct serum bilirubin levels were reevaluated in 95 newborns at 72 hours of age when jaundice appeared according to Kramer's dermal zones.
  
  
  RESULTS
  Phototherapy treatment was needed in 14.7% of 95 patients. For recognition the newborns at high risk for developing hyperbilirubinemia, using a CBBil cut-off level of 2.60 mg/dl, we found a positive predictive value of 41.18%, negative predictive value of 97.9% and sensitivity of 50%.
  
  
  CONCLUSIONS
  Newborns with CBBil values below 2.6 mg/dl are at very low risk of developing hyperbilirubinemia and further need of phototherapy. Knowledge of low risk of hyperbilirubinemia in a newborn could encourage the physicians in the decision of early postnatal discharge.
authors: Istanbul Medipol University School of Medicine, Istanbul, Turkey. ipekilke70@gmail.com
authors: Ilke Ozahi
authors: IO
authors: Ipek
authors: Abdulkadir
authors: A
authors: Bozaykut
authors: Serap Ceran
authors: SC
authors: Çağrıl
authors: Rabia Gönül
authors: RG
authors: Sezer
mesh_terms: D001663:Bilirubin / Q000032:analysis / Q000097:blood* / Q000378:metabolism; D015331:Cohort Studies; D003657:Decision Making; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D010789:Phototherapy; D010820:Physicians; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D013997:Time Factors; D014421:Turkey
chemical_list: D001663:Bilirubin