©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Mar 9, 2026; 15(1): 112088
Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.112088
Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.112088
Comparison of bilirubin albumin ratio and total serum bilirubin for predicting neurological dysfunction in newborns: A meta-analysis
Nabeel Ahmad, Uzair Ahmed, Ghulam Mohy Ud Din, Department of Pediatrics, Lahore General Hospital, Lahore 54000, Punjab, Pakistan
Mavia Habib, Department of Cardiology, Services Institute of Medical Sciences, Lahore 54000, Punjab, Pakistan
Muhammad Shaheer Luqman, Department of Medicine, Ameer-Ud-Din Medical College, Lahore 54000, Punjab, Pakistan
Muhammad Talha, Muneeb Saifullah, Department of Medicine, King Edward Medical Univer
Ikra Rana, Department of Medicine, International School of Medicine, International University of Kyrgyzstan, Bishkek 720074, Kyrgyzstan
Author contributions: Ahmad N and Ahmed U collected data and drafted the manuscript; Ahmad N, Ahmed U, Mohy Ud Din G, Habib M, Luqman MS, Saifullah M and Rana I conceived the study and contributed to its design; Mohy Ud Din G, Habib M, Talha M and Rana I participated in data analysis and literature review; Luqman MS and Saifullah M contributed to manuscript editing and critical revisions; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Ikra Rana, MD, Department of Medicine, International School of Medicine, International University of Kyrgyzstan, 6 Street, Bishkek 720074, Kyrgyzstan.
Received: July 17, 2025
Revised: August 9, 2025
Accepted: October 28, 2025
Published online: March 9, 2026
Processing time: 232 Days and 18.6 Hours
Revised: August 9, 2025
Accepted: October 28, 2025
Published online: March 9, 2026
Processing time: 232 Days and 18.6 Hours
Core Tip
Core Tip: Bilirubin-induced neurologic dysfunction (BIND) remains a preventable cause of neonatal brain injury, yet early risk stratification is challenging. We conducted a meta-analysis of observational studies using clinical criteria to diagnose BIND and found that elevated serum bilirubin/albumin (B/A) ratio is significantly associated with increased risk of BIND. This association remained robust across subgroup and meta-regression analyses. Our findings support the B/A ratio as a simple, accessible biomarker that may improve clinical prediction of BIND and guide early intervention in jaundiced neonates.