Role of Cord Blood Alkaline Phosphatase as a Predictor for Hyperbilirubinemia in Full-term Neonates

Background: Neonatal hyperbilirubinemia is a common clinical condition among newborns that requires early detection and medical management to avoid bilirubin toxicity. This study aimed to investigate the role of cord blood alkaline phosphatase (ALP) levels as a predictor of hyperbilirubinemia in full-term neonates. Methods: This cross-sectional study was conducted on full-term newborns within April-August ۲۰۱۹ in several hospitals in Medan, Indonesia. Cord blood ALP levels upon delivery and serum bilirubin levels on ۷۲ h of life were measured. Results: Out of ۱۴۷ full-term neonates, the mean cord blood ALP levels and serum bilirubin levels were obtained at ۱۶۶.۳±۴۵.۱ IU/l and ۹.۶±۲.۳ mg/dl, respectively. There was a significant difference in mean cord blood ALP levels at serum bilirubin levels of >۱۰ mg/dl and ≤۱۰ mg/dl on ۷۲ h of life (۱۹۶.۸±۴۰.۷ IU/l and ۱۴۶.۴±۳۷.۵ IU/l, respectively; P=۰.۰۰۱). A positive, moderate, and significant correlation was observed between cord blood ALP levels and serum bilirubin levels on ۷۲ h of life (r=۰.۴۲۹; P=۰.۰۰۱). The cut-off value of ۱۶۳.۵ IU/l was associated with ۸۴.۷% sensitivity and ۷۷.۳% specificity for predicting hyperbilirubinemia in full-term neonates. Conclusion: There was a positive correlation between cord blood ALP levels and serum bilirubin levels on ۷۲ h of life. Therefore, cord blood ALP may be utilized as a predictor for hyperbilirubinemia in full-term neonates.    

Keywords:

Alkaline phosphatase , Hyperbilirubinemia , Full-term neonates