الفهرس 
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Abstract
Neonatal jaundice occurs in approximately two thirds of all newborns in the first postnatal week. In significant number (6.5%) of babies, Neonatal Hyperbilirubinemia is the most common cause for readmission during the early neonatal period.
American Academy of Pediatrics recommends that neonate discharged within 48 hours should have a follow up visit after 48 to 72 hours for any significant jaundice and other problems.
The present study was conducted to find out the critical value of cord serum albumin in predicting the subsequent development of hyperbilirubinemia in healthy term and newborn.
This study was conducted on 83 full term neonates 48 males and 35 females delivered in El Menoufia University Hospital and El Mansoura international Hospital in the period between April 2012-december 2014. The study was approved by the ethics committee of faculty of medicine, Menoufia University.
A consent was taken from each mother to be included in this study.
Inclusion criteria:
5. Full term newborns ( gestational age≥37 completed weeks) .
6. Both genders.
7. Any birth weight.
8. APGAR score of more than 7 at first and fifth minute of life.
Exclusion criteria include:
5. Prematurity.
6. Low APGAR score of less than 7 at first and fifth minute of life.
7. Newborns who later developed any complications ( respiratory distress, sepsis and direct hyperbilirubinemia ).
8. Rh or ABO incompatibility between mother and newborn.
All cases were subjected to the following:
I)Careful history taking.
II)Thorough clinical examination .
III)Laboratory investigation.
The studied cases were divided into two groups::
Cases group which included 19 neonates who developed significant hyperbilirubinemia.
Control group which included 64 neonates who did not developed significant hyperbilirubinemia.
Also all studied cases were divided according to cord serum albumin level into three groups .
Group I:Cord serum albumin level (≤2.8g/dl) 8 full term neonates, 3males and 5 females.
Group II: Cord serum albumin level (2.9-3.3g/dl) 30 full term neonates , 17males and 13 females.
Group III: Cord serum albumin level (≥3.4g/dl) 45 full term neonates, 28 males and 17 females.
Four ml of cord blood was collected during delivery from placental end, 2 ml of them put in clean capped tube, serum was immediately analyzed for cord serum albumin .The other 2 ml put in EDTA tube and sent for complete blood picture, blood group & Rh for newborns and reticulocyte count.
The newborns were followed up clinically for jaundice by dermal Kramer zones in the first five days of life.
Newborns showed clinical jaundice in the first 5 days are subjected to serum bilirubin measurements. Those who did not show clinical jaundice are subjected to serum bilirubin measurement in the fifth day.
Our results were collected, tabulated and analyzed using computer programs SPSS (Statistical Package for the Social Science; SPSS Inc., Chicago, IL, USA) version 15 for Microsoft Windows.
Our results showed that:
1. There was significant difference between cases and control groups and as regard to the gestational age. But there was no significant difference as regard to maternal age, sex of neonates and mode of delivery.
2. There was no significant difference between cases and control groups as regard to weight ,length ,head circumference ,order of birth or APGAR score at 1st and 5th minute.
3. There was significant difference between cases and control groups as regard to albumin level and bilirubin level, (albumin level was higher in control group while bilirubin level was lower in control group ).But there was no significant difference
as regard to hemoglobin ,RBCs ,HCT % ,WBCs or PLT and Reticulocyte count% .
4. As regard to group I (cord serum albumin ≤ 2.8 g/dl) 75% of neonates developed hyperbilirubinemia requiring treatment with phototherapy and 25% needed no treatment for hyperbilirubinemia. While in group II(cord serum albumin 2.9-3.3 g/dl|)40% of neonates developed hyperbilirubinemia requiring treatment with phototherapy and 58.1% needed no treatment for hyperbilirubinemia. And in groupIII ( cord serum albumin ≥3.4 g/dl) none of neonates needed treatment for hyperbilirubinemia.
5. There was high significant positive correlation between cord serum albumin level in the studied neonates and gestational. And there was no significant correlation between cord serum albumin level in the studied neonates and maternal age.
6. There was no significant correlation between cord serum albumin level in the studied neonates and weight ,head circumference, order of birth and APGAR score at 1st or 5th minute.
7. There was no significant correlation between cord serum albumin level in the studied neonates and hemoglobin and HCT%. While there was significant negative correlation between cord serum albumin level in the studied neonates and serum bilirubin level at 5th day.