International Journal of
MediPharm Research

Neonatal hyperbilirubinemia remains one of the most frequent metabolic conditions encountered in the early neonatal period, with potential progression to bilirubin encephalopathy if not identified and managed promptly. From a pharmacotherapeutic standpoint, serum albumin plays a critical role in modulating bilirubin toxicity through high-affinity binding of unconjugated bilirubin, thereby reducing the free bilirubin fraction available for neurotoxic interactions. Consequently, cord serum albumin concentration at birth has been proposed as a clinically relevant biomarker to stratify the risk of hyperbilirubinemia and guide early therapeutic interventions. Aim: To evaluate the pharmacotherapeutic relevance of cord serum albumin as a predictive biomarker for neonatal hyperbilirubinemia and to analyze bilirubin kinetics using sequential transcutaneous bilirubin (TCB) monitoring. Methods: A prospective observational study was conducted in the Department of Paediatrics, SDM College of Medical Sciences and Hospital, Dharwad, from June 2021 to June 2022. Fifty term neonates fulfilling inclusion criteria were enrolled. Cord serum albumin was quantified using the SIEMENS EXL-200 analyzer. Bilirubin progression was assessed using serial TCB measurements recorded at 12, 24, 36, 48, 72, and 96 hours with a Dräger JM-103 jaundice meter. Total serum bilirubin was estimated by the diazo method whenever clinically indicated. Statistical analysis was performed using SPSS version 22.0, with significance set at p < 0> 0.05). Birth weight, however, demonstrated a significant correlation with phototherapy need (p = 0.003), highlighting its importance as a complementary risk determinant. Conclusion: Cord serum albumin demonstrated limited predictive utility for guiding early pharmacological decision-making in neonatal hyperbilirubinemia. In contrast, serial bilirubin monitoring and birth-weight assessment remain robust, clinically meaningful tools for anticipating the need for phototherapy. Integrating biochemical biomarkers with dynamic bilirubin kinetics may enhance precision in neonatal pharmacotherapy and individualized care. Keywords: Serum albumin; Neonatal hyperbilirubinemia; Pharmacotherapy; Transcutaneous bilirubin; Biomarker; Phototherapy