Comparison of transcutaneous bilirubinometery and total serum bilirubin in icteric newborns

Abstract

Background: Hospitalization, follow-up, and total serum bilirubin (TsB) testing are required in instances with a high risk of kernicterus, including day-one icter, hepatosplenomegaly, and other similar conditions. For non-invasive testing, transcutaneous bilirubinometry (TcB) is one option.
Objective: Assessment of the accuracy of transcutaneous bilirubinometry in comparison to serum total bilirubin level.
Subjects and methods: This hospital-based study was carried out at the Neonatal Care Unit of Zagazig University Teaching Hospital on 108 healthy neonates suspected on clinical grounds of having neonatal jaundice, of whatever etiology, admitted to the unit for hyperbilirubinemia. Gestational age was estimated from obstetric history and new Ballard Score method.
Result: TsB mean ± SD and TcB differed significantly from each other. At the 2-day, 3-day, 4-day, and 5-day points after the initial measurement, there was a statistically significant difference between the total serum bilirubin and transcutaneous bilirubin levels, when categorized by age. There were extremely significant differences between preterm and full-term newborns in terms of platelet count, C-reactive protein, total serum bilirubin, and transcutaneous bilirubin level. Levels of total serum bilirubin and transcutaneous bilirubin were stratified from 2^nd to 5^th day of measurement according to age as follows: TcB average, TcB over sternum, and TcB over forehead, and were significantly different.
Conclusion: The great sensitivity of TcB makes it a potential tool for the prediction of neonatal icter. Nevertheless, in newborns who are at high risk of jaundice, it should not be used as a replacement for TsB measurement.