Comparative study between serum and transcutaneous bilirubin measurements in new-borns

Abstract

Background: Hyperbilirubinemia is one of the common problems in neonates. The transcutaneous bilirubin (TCB) measurement is non-invasive, easy and rapid not requiring expertise and manpower. Fewer studies have been carried out to whether newer TCB measurements can correlate with serum bilirubin measurements using newer generation of transcutaneous bilirubinometer in our region.Methods: An observational cross-sectional study to compare serum and transcutaneous bilirubin measurements in newborns admitted to a neonatal intensive care unit, conducted from December 2015 to November 2017. Blood samples were obtained from neonates collected from venous sample into plain bulb and sent for analysis. For transcutaneous bilirubin measurement, the reading from forehead and sternum were taken using bilirubinometer and an average reading was taken for comparison.Results: Total 172 neonates were admitted during study period and enrolled in the study. It was observed that out of 172 patients, studied 102(59%) patients were male and 70(41%) patients were female. Out of 172 patients maximum 89(51.74%) mother have O positive blood group and only 2(1.1%) have O negative blood group. Common cause of neonatal hyperbilirubinemia was ABO incompatibility 81(48%), Rh incompatibility 11(6%), and other causes 80(46%). The mean and standard deviation of TSB for first, second and third reading were 19.21±3.44, 15.76±2.79 and 12.89±2.44 respectively. While mean and standard deviation of TCB for first, second and third reading were 18.34±2.99, 15.48±2.36 and 12.31±2.28 respectively with correlation coefficient of r=0.806513, r=0.694273, r=0.785471 respectively indicating linear relationship between two.Conclusions: There was a strong correlation between serum and transcutaneous bilirubin levels before and even after the phototherapy. As transcutaneous bilirubin estimation is non-invasive, gives quick and reproducible results. So, by using this method has potential screening value especially in the high-risk neonates to start early intervention.