Hypoalbuminemia in Jaundice Neonatorum among Term Newborns at a Tertiary Care Hospital

Abstract

Background: Jaundice which occurs in about 60% term and more than 80 % preterm neonates. It remains on the most common morbidities observed in the first week of life of newborns and is most prevalent cause of re-hospitalization after their discharge from birth hospitalization. This study was conducted to document the frequency of hypoalbuminemia in neonatum jaundice as there is no such study conducted in Pakistan. Objective: To determine  the frequency of hypoalbuminemia in jaundice neonatorum in term infants. Material and methods: A total of 265 patients fulfilling the inclusion criteria from indoor department of pediatrics Nishtar hospital Multan were included in the study from May 2016 to May 2017. Demographic information of patients (gestational age, mode of delivery, gender, weight) was taken and recorded in study proforma. Three ml blood sample was collected from all participants for serum albumin levels and hypoalbuminemia was defined as serum albumin level of less than 2.5 g/dL by laboratory test. Data was analyzed with statistical analysis program (SPSS version11.5). Results: Of these 265 study cases, 150 (56.6%) were boys while 115 (43.4%) were girls. Mean gestational age of our study cases was 39.84 ± 1.67 weeks (with minimum gestational age was 37 weeks while maximum was 42 weeks). Mean gestational age of the boys was 40.41 ± 1.42 weeks while that of girls was 39.10 ± 1.69 weeks. Our study results have indicated that majority of our study cases i.e. 160 (60.4%) had gestational age ranging from  40- 42 weeks. Majority of these babies i.e. 222 (83.8%) were born through vaginal mode of delivery. Mean weight of our study cases was 3084.08 ± 344.422 grams (with minimum weight was 2550 grams while maximum weight was noted to be 3750 grams). Majority of our study cases i.e. 150 (56.6%) were from rural areas and 115 (43.3%) belonged to the urban areas. Of these 265 study cases, 104 (39.2%) were from poor socioeconomic background while 125 (47.2%) had middle income. Mean level of serum albumin was 2.55 ± 0.31 g/dl (with minimum albumin level was 2.2 and maximum was 3.6). Hypoalbuminemia was seen in 141 (53.2%) of our study cases.Conclusion: In our study, very high frequency of hypoalbuminemia has been noted in neonates presenting with jaundice. Neonatal jaundice was more prevalent in boys than girls. Hypoalbuminemia was significantly associated with rural residential status, vaginal mode of delivery and poor socioeconomic status.

Keywords: Hyperbillirubinemia, hypoalbuminemia, jaundice.