Title:Study of Cord Blood Levels of Erythropoietin, Bilirubin and Reticulocyte Count as Early Predictors of Neonatal Hyperbilirubinemia
Volume: 21
Author(s): Mohamed S. Elfarargy*, Ghada M. Al-Ashmawy, Sally Abu-Risha and Haidy Khattab
Affiliation:
- Department of Pediatrics, Faculty of Medicine, Tanta University,Egypt
Keywords:
Neonate, hyperbilirubinemia, erythropoietin, bilirubin, reticulocyte count, predictors.
Abstract:
Background: Neonatal hyperbilirubinemia is a serious neonatal problem which has
hazardous effects on the neonates when the level of indirect bilirubin is increased to the levels that
could cause kernicterus.
Aims: The aim of this research is to study the cord blood levels of erythropoietin (EPO), bilirubin
and reticulocyte count (RC) as early predictors of neonatal hyperbilirubinemia.
Methods: This is a case-control study, which was conducted at Tanta University Hospital (TUH)
from July 2016 to March 2018 on 90 neonates. The studied neonates were divided into 2 groups:
Group 1 (45 neonates) who developed pathological hyperbilirubinemia and required treatment and
group 2(45 neonates) who did not develop pathological hyperbilirubinemia and did not require
treatment. Cord blood levels of EPO, bilirubin and RC were measured in all the studied neonates in
both groups.
Results: There was a significant difference between both groups with regard to cord blood bilirubin
(CBB), hemoglobin, EPO and RC levels where the P. value is 0.001*,0.027,
*0.001*&0.001*respectively. There was a significant positive correlation between cord blood EPO
levels and both CBB and cord blood RC with r=0.610 and 0.579, respectively and P. value is
0.001* & 0.001* respectively. With regard to ROC curve, there were high cord blood EPO levels
where the cut off value was 22.5 mIU/ml while the sensitivity and specificity were 96 and89, respectively.
In the cord blood RC, the cut off value was 5.7% while the sensitivity and specificity
were 93 and 85, respectively, and lastly, CBB where the cut off value was 1.8 mg/dl while the sensitivity
and specificity were 89 and 78 respectively.
Conclusion: Cord blood levels of EPO, bilirubin and RC were increased in cases of pathological
neonatal hyperbilirubinemia.
Recommendation: Cord blood levels of EPO, bilirubin and RC could be used for early prediction
of pathological neonatal hyperbilirubinemia.