European Journal of Cardiovascular Medicine

Background: Neonatal hyperbilirubinemia is a frequent illness that occurs in newborns during their first week of life. Due to social reasons, such as an early naming ceremony, the risk of nosocomial infections, and financial constraints, early discharge of healthy term neonates is a typical practice. Neonatal hyperbilirubinemia is the most frequent reason for readmission in a sizeable number of neonates. Early discharge of healthy term neonates is a worry because there have been reports of bilirubin-induced brain injury and its sequelae, like kernicterus. Early hyperbilirubinemia detection in neonates is crucial, for this reason. Aims and Objective: To study the efficacy of cord blood albumin as a predictor of neonatal jaundice and to study their association with significant hyperbilirubinemia requiring further intervention. Materials and methods: The prospective study conducted in Department of Pediatrics at Rajshree Medical & Research Institute, between 15 January 2021 to 14 January 2022. Cord blood was sent for albumin analysis and fourth day venous sample was sent for serum bilirubin and blood group analysis. Results: This study enrolled 119 term neonates. Out of which 15 neonates had albumin level less than 2.9mg/dl, 61 neonates between 2.9mg/dl-3.3mg/dl and 43 neonates above 3.4mg/dl. Out of total study subject enrolled 11.8% required intervention like phototherapy. Conclusion: From this study, cord blood albumin level was demonstrated as predictive marker for neonatal hyperbilirubinemia with a sensitivity of 60%

Background: Rh isoimmunization is a condition that occurs when a woman with Rh negative blood type becomes sensitized to Rh positive blood cells during childbirth, miscarriage, abortion, medical procedures like invasive prenatal testing (e.g., amniocentesis) trauma to the abdomen during pregnancy or transfusion with Rh positive blood. With each successive pregnancy, there is a cumulative effect of fetomaternal transfusions thus increasing the severity of the problem at hand. It can lead to hemolytic disease of the newborn which can range from mild to severe, including features such as anemia, jaundice, hepatospleenomegaly, and, in severe cases, hydrops fetalis.  Such newborns may require treatments such as phototherapy for jaundice, blood transfusions, IV immunoglobulins, and in severe cases, exchange transfusions. Aim: To study the role of cord bilirubin as a non invasive, early predictive marker of hemolysis in Rh positive neonates delivered to Rh negative mothers. Study Type and Design: Observational, descriptive, longitudinal study. Materials:  Rh positive neonates delivered in OT/labor room of our hospital to Rh negative mothers studied according to specific protocol. Study Setting: Neonatal and postnatal wards of a rural tertiary care hospital. Period of Study:  (Two years) From June 2022 to June 2024. Ethical Committee consent was taken at the start of the study. Data was entered in excel sheets and analyzed using IBM SSPS Statistics software. Results: Out of 277 neonates delivered at term to Rh negative mothers in the study duration, 158 were Rh positive and 119 were Rh negative mothers. A cord bilirubin cutoff of >1.9 mg/dL was found to have excellent specificity (97.8%) and positive predictive value (95.74%), making it a robust tool for identifying newborns at high risk of hyperbilirubinemia, with a sensitivity of 67.16% and a negative predictive value of 80.18%. For the phototherapy group, the average cord bilirubin level was found to be 2.13 ±0.51 mg/dL, as compared to the no phototherapy group, wherein the average cord bilirubin level is 0.80±0.58 mg/dL. Cord bilirubin values >1.9 mg/dl (seen in 29.7% of the study population) were found to have a statistically significant association with a need for interventions (phototheraphy and/or exchange transfusion) with a p value <0.05. Conclucion: Hemolysis due to Rh isoimmunization is more frequent and severe in neonates of multigravida mothers as Zompared to neonates of primigravida mothers, due to the cumulative effect of fetomaternal transfusions in each successive pregnancy. Cord sampling proves to be an essential predictive marker of the risk of hemolysis in the neonate earlier to allow for early initiation of therapeutic measures and reducing the risk of rapid hemolysis and further, long term complications such as bilirubin encephalopathy, emerging as a cornerstone of non invasive care.

Introduction: During pregnancy, maternal thyroid hormones are essential for placental function and fetal brain development, particularly in the first trimester before the fetal thyroid becomes functional. Maternal hypothyroidism has been linked to various adverse outcomes, including neonatal jaundice, hypocalcemia, respiratory distress, and increased risk of congenital anomalies.Early diagnosis and appropriate treatment with levothyroxine significantly reduce these risks, making maternal thyroid health crucial for optimal pregnancy outcomes. Materials And Methods: A hospital-based observational study was conducted over 1.5 years in the Department of paediatrics of Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. The study included 50 neonates with hypothyroid mother.Another set of 50 neonates born to pregnant subjects with absence of maternal hypothyroidism or any other thyroid related disorder were included as controls.. Infants with birth asphyxia, congenital anomalies, sepsis, metabolic disorders, or born to diabetic or anticonvulsant- using mothers were excluded. Results: The number of neonates born by LSCS  was significantly higher in hypothyroid mothers (66% vs. 14%, p=0.001). Preterm deliveries (18% vs. 4%, p=0.001), low birth weight (30% vs. 2%, p=0.000), and small for gestational age neonates (20% vs. 0%, p=0.000) were significantly more common in the hypothyroid group. Mean birth weight was significantly lower in the hypothyroid group (p=0.001), while no significant differences were found in neonatal gender, APGAR scores, cord/serum TSH, NICU admission or stay, or respiratory complications. Conclusion: Neonates born to hypothyroid mothers had higher rates of cesarean delivery, low birth weight, SGA, and neonatal jaundice requiring phototherapy.