Abstract
Introduction: Most neonatal hyperbilirubinemia is benign, but because of the potential toxicity of bilirubin, neonates should be monitored to identity those who might develop severe hyperbilirubinemia.
Objective: To determine if the cord blood hydrogen peroxide level can be used as an early predictor of neonatal hyperbilirubinemia or not and if there is a correlation between its levels and the severity of hyperbilirubinemia.
Methods: This is a prospective comparative study included 59 full term neonates. Forty-one neonates developed jaundice (group I) and 18 neonates did not develop jaundice (group II) as controls. For all studied groups, we measured the cord blood bilirubin using modified diazo method and hydrogen peroxide levels using ELISA Kits and we measured their levels at 5^th and 7^th days of life for patients.
Results: The cord blood H₂O₂ levels as well as the bilirubin levels were higher in patients than controls. Significant positive correlations between cord blood H₂O₂ and cord blood bilirubin levels were present (r=0.81& p<0.001), bilirubin levels at the 5^th day of life (r=0.46& p<0.001) and bilirubin levels at the 7^th day (r=0.60 & p<0.001). Moreover, there was a significant positive correlation between the 5^th day H₂O₂ and the 5^th day bilirubin levels (r=0.75& p<0.001) and a strong significant correlation between 7^th day H₂O₂and 7^th day bilirubin (r=0.94 & p= 0.001). The sensitivity of the cord blood H₂O₂ in cases as a predictor to neonatal hyperbilirubinemia was 92.6% and the specificity was100% with a cutoff point >35 (p-value 0.001).
Conclusion: Cord blood hydrogen peroxide (H₂O₂) levels can be used as an early predictor of neonatal indirect hyperbilirubinemia and can determine which neonates should be followed after discharge from the hospital.