Incidence and risk factors for low serum albumin concentrations in neonates evaluated for jaundice

ObjectiveTo examine the incidence and risk factors for low serum albumin concentrations in neonates evaluated for jaundice.MethodsA retrospective chart review was conducted on inborn neonates who were born at ≥35 weeks gestation and evaluated for jaundice at 3 university hospitals in Thailand from 1 January to 31 December 2023. The neonates' demographics, neurotoxicity risk factors, serum albumin concentrations, and maternal characteristics were analyzed. The neonates were classified into the hypoalbuminemia (<3.0 g/dL) and normal albumin (≥3.0 g/dL) groups. Univariate and multivariate regression analyses were used to identify the factors associated with hypoalbuminemia.ResultsAmong 902 neonates who had jaundice evaluation, 229 (25.4%) had serum albumin <3.0 g/dL. The hypoalbuminemia group had a lower gestational age and Apgar scores, a higher prevalence of male sex, and clinical instability or sepsis compared with the normal albumin group. Neonates in the hypoalbuminemia group were also younger at testing and their mothers were older than those in the normal albumin group. In the univariate analysis, male sex, clinical instability or sepsis, low gestational age, low birth weight, low Apgar scores, and increased maternal age were associated with hypoalbuminemia (p < 0.1). In the multivariate analysis, lower gestational age, male sex, and clinical instability or sepsis remained significant risk factors for hypoalbuminemia (all p < 0.05).ConclusionsAbout one-quarter of neonates evaluated for jaundice had serum albumin <3.0 g/dL. Lower gestational age, male sex, and clinical instability or sepsis were significant risk factors, suggesting that targeted albumin screening in these high-risk groups may be warranted.