{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T01:22:43Z","timestamp":1772760163880,"version":"3.50.1"},"reference-count":19,"publisher":"Baishideng Publishing Group Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Clin Pediatr"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Bilirubin-induced neurologic dysfunction (BIND) remains a serious complication of severe neonatal hyperbilirubinemia, especially in resource-limited settings. While total serum bilirubin (TSB) is widely used for risk stratification, the bilirubin\/albumin (B\/A) ratio has been proposed as a surrogate for free bilirubin, the neurotoxic fraction.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To compare the diagnostic accuracy of the B\/A ratio vs  TSB for predicting acute BIND in neonates.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>We conducted a systematic review and meta-analysis of observational studies evaluating the B\/A ratio and TSB for predicting BIND in neonates (\u2265 35 weeks' gestational age). Data sources included PubMed, EMBASE, Cochrane Central, and Google Scholar. Pooled standardized mean difference (SMD), sensitivity, specificity, and heterogeneity (I 2) were calculated using a bivariate random-effects model. Meta-regression was used to assess whether biomarker type (B\/A vs  TSB) explained performance differences. The risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>Five studies involving a total of 1022 neonates were included, with a male-to-female ratio of approximately 57:40. The SMD for B\/A ratio was 1.71 (95%CI: 1.00\u20132.41, P  &lt; 0.0001), and for TSB it was 1.68, both showing strong associations with BIND. Meta-regression revealed no significant difference in predictive value between the two biomarkers (P  = 0.96).<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>Both TSB and the B\/A ratio are comparably effective in predicting BIND. While the B\/A ratio may provide incremental value in specific clinical contexts, current evidence supports continued reliance on TSB for routine risk stratification.<\/jats:p>","DOI":"10.5409\/wjcp.v15.i1.112088","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:44:01Z","timestamp":1772757841000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparison of bilirubin albumin ratio and total serum bilirubin for predicting neurological dysfunction in newborns: A meta-analysis"],"prefix":"10.5409","volume":"15","author":[{"given":"Nabeel","family":"Ahmad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uzair","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghulam","family":"Mohy Ud Din","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mavia","family":"Habib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Shaheer","family":"Luqman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Talha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muneeb","family":"Saifullah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikra","family":"Rana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-305506"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(18)30139-1"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.060328"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2020-000845"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.218"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.21037\/pm-21-37"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1764"},{"key":"B8","unstructured":"Ardakani SB, Dana VG, Ziaee V, Ashtiani MT, Djavid GE, Alijani M. Bilirubin\/Albumin Ratio for Predicting Acute Bilirubin-induced Neurologic Dysfunction. Iran J Pediatr 2011; 28-32"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2024-007980"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/s43054-019-0010-x"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1042\/BSR20192152"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1186\/s43054-021-00050-6"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.9734\/jammr\/2024\/v36i25373"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n265"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.134056"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.4103\/mjdrdypu.mjdrdypu_1075_22"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-015-0355-2"},{"key":"B19","unstructured":"Patel E, Potey GG. A study on Bilirubin \/ Albumin Ratio in Prediction of Bilirubin Induced Neural Dysfunction in Neonatal Hyperbilirubinemia. Int J Biol Med Res 2014; 4554-4555"}],"container-title":["World Journal of Clinical Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/2219-2808\/full\/v15\/i1\/112088.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/2219-2808\/full\/v15\/i1\/112088.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:45:10Z","timestamp":1772757910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/2219-2808\/full\/v15\/i1\/112088.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":19,"journal-issue":{"issue":"1"},"alternative-id":["112088"],"URL":"https:\/\/doi.org\/10.5409\/wjcp.v15.i1.112088","relation":{},"ISSN":["2219-2808"],"issn-type":[{"value":"2219-2808","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}