Abstract
Neonatal jaundice is the result of an imbalance between bilirubin production and elimination. Bilirubin conjugation in newborns is significantly impaired in the first few days; even a small increase in the rate of production can contribute to the development of hyperbilirubinemia. Hemolysis has a significant role in bilirubin increase in newborns. Intrauterine is tolerated by the maternal metabolism in life. When hemolysis takes place, a decrease is accepted in the haptoglobin and hemopoexin blood levels binding hemoglobin in the environment. Therefore, it may be considered that haptoglobin and hemopoexin from the early period umbilical cord (UC) blood in newborns may be an indicator in determining jaundice likely to develop in later stages. Babies were called to the control polyclinic in the third and fifthdays. Eighty‐four babies with normal termbirth were included in the study. Gestational age of the mothers was 39.5±1.5 weeks in average. A significant negative correlation was found between the haptoglobin level from the UC taken during delivery and the bilirubin value in the fifth day (r=−0.345; P=0.001). The haptoglobin value from the blood of the UC can be used as a guiding indicator to demonstrate the future occurrence of jaundice in newborns. This way, the babies with high jaundice risk may be detected earlier and closer follow‐up of these babies can be obtained. As a result, the haptoglobin level of the blood from the UC during delivery allows us to make an early prediction on whether neonatal jaundice will occur. J. Clin. Lab. Anal. 22:409–414, 2008. © 2008 Wiley‐Liss, Inc.
Keywords: bilirubin, neonatal jaundice, haptoglobin, hemoglobin, hemolysis
REFERENCES
- 1. Maisels MJ, Newman TB. Kernicterus in otherwise healthy, breast‐fed term newborns. Paediatrics 1995;96:730–733. [PubMed] [Google Scholar]
- 2. Newman TB, Maisels MJ. Less aggressive treatment of neonatal jaundice and reports of kernicterus: Lessons about practical guidelines. Pediatrics 2000;105:242–245. [PubMed] [Google Scholar]
- 3. Knüpfer M, Pulzer F, Gebauer C, Robel‐Tillig E, Vogtmann C. Predictive value of umbilical cord blood bilirubin for postnatal hyperbilirubinaemia. Acta Paediatr 2005;94:581–587. [DOI] [PubMed] [Google Scholar]
- 4. Jiménez R, Figueras J, Botet F. Neonatologõá. Procedimientos Diagnósticos y Terapéuticos, second edition Barcelona: Ed. Espaxs; 1995; p 519–556. [Google Scholar]
- 5. Brown AK, Johnson L. Loss of concern about jaundice and the re‐emergence of kernicterus in full‐term infants in the era of managed care In: Fanaroff AA, Klaus M, editors. The Year Book of Neonatal Perinatal Medicine. St. Louis: Year Book, Mosby; 1996; p 17–18. [Google Scholar]
- 6. American Academy of Pediatrics . Committee on fetus and newborn. Hospital stay for healthy term newborn. Pediatrics 1995;96:788–790. [PubMed] [Google Scholar]
- 7. American Academy of Pediatrics . Provisional committee for quality improvement and subcommittee on hyperbilirubinemi a in the healthy term newborn. Practice parameter: management of hyperbilirubinemi a in the healthy term newborn. Pediatrics 1994;94:558–562. [PubMed] [Google Scholar]
- 8. American Academy of Pediatrics . The American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care, fourth edition. 1997.
- 9. Carbonell X, Botet F, Figueras J, Riu‐Godó A. Prediction of hyperbilirubinaemia in the healthy term newborn. Acta Paediatr 2001;90:166–170. [DOI] [PubMed] [Google Scholar]
- 10. Sarici SU, Yurdakök M, Serdar MA, et al. An early (sixth‐hour) serum bilirubin measurement is useful in predicting the development of significant hyperbilirubinemia and severe ABO hemolytic disease in a selective high‐risk population of newborns with ABO incompatibility. Pediatrics 2002;109:e53. [DOI] [PubMed] [Google Scholar]
- 11. Maisels MJ, Kring E. The contribution of hemolysis to early jaundice in normal newborns. Pediatrics 2006;118:276–279. [DOI] [PubMed] [Google Scholar]
- 12. Okuda M, Tokunaga R, Taketani S. Expression of haptoglobin receptors in human hepatoma cells. Biochim Biophys Acta 1992;1136:143–149. [DOI] [PubMed] [Google Scholar]
- 13. Oshiro S, Yajima Y, Kawamura K, et al. Catabolism of haemoglobin–haptoglobin complex in microsome subfractions. Chem Pharm Bull 1992;40:1847–1851. [DOI] [PubMed] [Google Scholar]
- 14. Delanghe JR, Langlois MR. Hemopoexin: A review of biological aspects and the role in laboratory medicine. Clin Chim Acta 2001;312:13–23. [DOI] [PubMed] [Google Scholar]
- 15. Ballard JL, Khoury JC, Wediq K, Wang L, Eilers‐Walsman BL, Lipp R. New Ballard score expanded to include extremely premature infants. J Pediatr 1991;119:417–423. [DOI] [PubMed] [Google Scholar]
- 16. Bhutani VK, Johnson LH. Managing the assessment of neonatal jaundice: Importance of timing. Indian J Pediatr 2000;67:733–737. [DOI] [PubMed] [Google Scholar]
- 17. Bhutani VK, Johnson L, Sivieri EM. Predictive ability of predischarge hour specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near‐term newborns. Pediatrics 1999;103:6–14. [DOI] [PubMed] [Google Scholar]
- 18. Alpay F, Sarici SU, Tosuncuk HD, Serdar MA, Inanç N, Gökçay E. The value of first‐day bilirubin measurement in predicting the development of significant hyperbilirubinemia in healthy term newborns. Pediatrics 2000;106:E16. [DOI] [PubMed] [Google Scholar]
- 19. Maisels MJ, Newman TB. Jaundice in full‐term and near‐term babies who leave the hospital within 36 hours: The pediatrician's nemesis. Clin Perinatol 1998;25:295–302. [PubMed] [Google Scholar]
- 20. Stevenson DK, Fanaroff AA. Prediction of hyperbilirubinemia in near‐term and term infants. Pediatrics 2001;108:31–39. [DOI] [PubMed] [Google Scholar]
- 21. Bhutani VK, Johnson LH. Managing the assessment of neonatal jaundice: Importance of timing. Indian J Pediatr 2000;67:733–737. [DOI] [PubMed] [Google Scholar]
- 22. Bhutani VK, Johnson LH, Sivieri EM, et al. Universal newborn bilirubin screening. Pediatr Res 1997;41:191. [Google Scholar]
- 23. Johnson L, Bhutani VK. Guidelines for management of the jaundiced term and near‐term infant. Clin Perinatol 1998;25:555–574. [PubMed] [Google Scholar]
- 24. Martinez JC, Othegui LE, Garcõá HO, et al. Hyperbilirubinemia in the healthy term breast‐fed newborn: conclusions of a close follow‐up. Abstracts Ross Special Conference. Hot Topics in Neonatology, Washington, DC. 1996. p 517–520.
- 25. Sheidman DS, Ergaz Z, Revel‐Vilk R, Stevenson DK, Paz I, Gale R. 1996. The use of bilirubin measurements on the first day of life for prediction of neonatal jaundice. Abstracts Ross Special Conference. Hot Topics in Neonatology, Washington, DC. p 284–294.
- 26. Brown AK, Damus K, Kim MH, et al. Factors relating to readmission of term and near‐term newborns in the rst two weeks of life. Early discharge survey group of the health professional advisory board of the greater New York chapter of the March of dimes. J Perinat Med 1999;27:263–275. [DOI] [PubMed] [Google Scholar]
- 27. Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics 1998;101:995–998. [DOI] [PubMed] [Google Scholar]
- 28. Maisels MJ, Newman TB. Jaundice in full‐term and near term babies who leave the hospital within 36 hours. Clin Perinatol 1998;25:295–302. [PubMed] [Google Scholar]
- 29. Maisels MJ, Newman TB. Predicting hyperbilirubinemia in newborns: The importance of timing. Pediatrics 1999;103:493–494. [DOI] [PubMed] [Google Scholar]
- 30. Carter K, Worwood M. Haptoglobin: A review of the major allele frequencies worldwide and their association with diseases. Int J Lab Hematol 2007;29:92–110. [DOI] [PubMed] [Google Scholar]
