Hubungan Kadar Albumin Darah Tali Pusat dengan Terjadinya Ikterus Neonatorum pada Bayi Baru Lahir Cukup Bulan

Abstract

Background: Neonatal jaundice is a common clinical problem during the neonatal period, especially in the first week of life, which is characterized by a yellowish discoloration of the skin and sclera due to the accumulation of the yellow pigment bilirubin. Healthy infants can develop idiopathic neonatal jaundice with a prevalence of 60% - 80%. The liver is the site of albumin synthesis. Albumin binds unconjugated bilirubin from the breakdown of erythrocytes and helps in transport to the liver resulting in very little unconjugated (indirect) bilirubin levels in the blood circulation. Low albumin production will reduce the transport and binding capacity resulting in albumin levels can be an indicator in determining the occurrence of neonatal jaundice in newborns. The purpose of this study was to assess the relationship between umbilical cord blood albumin levels and the occurrence of neonatal jaundice in term newborns. Method: This study is a prospective cohort of term neonates with normal birth weight of 2500-4000 grams from February 2020 until December 2020 according to the inclusion and exclusion criteria. Examination of the umbilical cord blood albumin level (mother's portion) was performed with a blood puncture of ± 3 mL after the umbilical cord was clamped and cut. Infants were followed up every day with the Kramer method until the baby was planned to discharge. Blood samples were taken on the third day of infants to assess bilirubin levels by laboratory analysts at H. Adam Malik hospital. Characteristics of children and parents are recorded. Result : This study was followed by 38 newborns at the RSUP. H. Adam Malik Medan, 18 newborns were excluded and 20 newborns met the inclusion criteria. The correlation of umbilical cord blood albumin levels with total serum bilirubin and indirect bilirubin levels on the third day showed a negative correlation (r value -0.759 and r -0.851) with p value <0.001 indicating a significant correlation. Meanwhile, there was no significant correlation between umbilical cord blood albumin and direct bilirubin with r value is -0,442 and p value is 0.051. The regression equation obtained is indirect bilirubin = 23,007 – 4,108 umbilical cord albumin levels. Based on this equation, indirect bilirubin levels can be estimated based on the value of umbilical cord albumin. Conclusion : Cord blood albumin levels can predict the occurrence of neonatal jaundice in term newborns.