Evaluating the Diagnostic Value of Skin Bilirubin in Comparison with Plasma Bilirubin to Identify Hyperbilirubinemia in Healthy Babies

Abstract

Background: An elevated level of bilirubin in the blood is the most common and benign problem among newborns; it is also the most important factor in the evaluation of neonatal jaundice in newborns. If severe indirect hyperbilirubinemia is left untreated, it can be neurotoxic; therefore, doctors cannot overstate the need for the early detection of hyperbilirubinemia. Objectives: We investigated the relationship between the skin and plasma methods of the quality of the BiliChek process as a means of diagnosing hyperbilirubinemia Patients and Methods: This study was performed at Amiralmomenin hospital in Semnan, Iran and examined 64 healthy infants who had gestational ages of 37 weeks and greater and jaundice as their sole cause for hospitalization. Infants hospitalized due to other diseases, such as sepsis, were excluded from the study. First, a blood sample was taken to determine the infants’ serum total bilirubin. Then, the amount of bilirubin was determined with BiliChek placed on three locations: the infants’ foreheads, chests, and left thighs. Results: SD ± mean values of the skin method on each forehead, chest, and thigh were respectively (3.5 ± 13.8, 12.8 ± 3.5 and 9.7 ± 2.6 mg per deciliter); using the plasma method, bilirubin SD ± mean was 14.4 ± 4.0, so that the skin method in all three areas was lower than the plasma method. Variables such as the type of delivery, birth rank, blood type, birth weight, and maternal age are independent of hyperbilirubinemia level, and there is no significant relationship between them. There is only a significant relationship between bilirubin levels and a baby’s age, as there is a significant relationship to birth (P = 0.000). Cut off point for the use of BiliChek in the forehead has been set at 3.13 milligrams per deciliter, and the sensitivity and specificity levels are 83.87% and 92.59%, respectively. As for the chest, it was 3.13 mg dL, with sensitivity and specificity levels of 83.87% and 96.30%, respectively. For the thigh, it was 9.7 mg per dL, with sensitivity and specificity levels of 83.87% and 96.30% respectively. There is no significant difference between the three areas mentioned in the skin method for predicting hyperbilirubinemia. Conclusions: In our study, we determined that BiliChek can be used in the diagnosis of hyperbilirubinemia, but this use is limited and applies only to the cutoff point and for values higher than the cutoff point. BiliChek is used as a means of screening for infants that need blood sampling.