Comparative study of total serum bilirubin levels measured via blood vs skin in neonates

Abstract

ObjectiveThe aim was to compare between total bilirubin levels measured via blood vs skin in neonates.BackgroundNeonatal jaundice is a common clinical problem. total serum bilirubin (TSB) with transcutaneous bilirubin (TCB) measurement can be used for evaluating bilirubin levels in neonates.Patients and methodsThis cross-sectional study was conducted on 200 jaundiced neonates with indirect hyperbilirubinemia, in the neonatal intensive care unit of Menoufia University Hospital, and they were randomly divided into three groups: group 1 (n = 100) included full-term neonates with gestational age ranged from 37 to 42 weeks; group 2 (n = 35) included late preterm neonates with gestational age ranged from 34 to 36 weeks; and group 3 (n = 65) included early preterm neonates with gestational age ranged from 30 to 33 weeks. Complete blood count with reticulocyte count was obtained along with TSB, Rhesus factor, and ABO blood groups for both mothers and neonates.ResultsThere was a strong positive significant correlation between TSB and TCB, but the correlation decreased as both levels advanced [Pearson correlation (r)=0.983]. The correlation was better in full tem with TSB-TCB difference of 1.88 ± 0.39 in comparison with late and early preterm, which was 2.27 ± 1.99 and 2.55 ± 0.64, respectively. There was a strong positive correlation between TSB and TCB regarding weight, gestational age, and postnatal ages, with Pearson correlation of 0.08, 0.404, and 0.505, respectively, for TSB and 0.477, 0.489, and 0.558, respectively, for TCB. TSB always overestimates TCB.ConclusionTCB is a reliable method in screening of neonatal jaundice in full-term babies, reducing the need for TSB, which is expensive and invasive. Reliability is lesser for the preterm.