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.