Abstract
The aim of this prospective study was to evaluate the accuracy of transcutaneous bilirubinometry using the Minolta Air-Shields JM-103 device in preterm newborns of gestational age 32-34 weeks, and to identify the most appropriate measurement site. Transcutaneous bilirubin (TcB) measurements were performed over forehead, sternum and abdomen, if total serum bilirubin (TSB) had to be determined on clinical indication in neonates of selected gestational age. TSB levels were measured in a clinical laboratory using direct spectrophotometry. In order to assess transcutaneous bilirubinometry accuracy, differences between TSB and TcB, their CI 95%, and correlation coefficients (r) between TcB and TSB were evaluated. The study group consisted of 44 infants, including 6 very low birth weight (VLBW) neonates. The correlations between transcutaneous and laboratory values were found to be significant and close. Minimal differences were observed when measured over sternum. The measurements over forehead had a tendency to underestimate TSB levels. Noninvasive measurement by Minolta JM-103 demonstrated significant accuracy. The authors recommend measurements over sternum or abdomen in premature infants born within 32-34 gestational weeks as a reliable and accurate neonatal hyperbilirubinemia screening test. Transcutaneous bilirubinometry has the potential to reduce the number of blood samplings, thus reducing neonatal pain and discomfort, parental distress and medical care cost.
Highlights
Neonatal jaundice remains an important neonatal issue
In order to reduce the risk of developing serious hyperbilirubinemia, phototherapy is the method of choice
The infants born within 32–34 gestational weeks who required Total serum bilirubin (TSB) level measurement on clinical indication within the first two weeks of life were included in the study
Summary
Neonatal jaundice remains an important neonatal issue It is one of the most common symptoms found in newborn babies, and the condition is mostly benign. Total serum bilirubin (TSB) level assessment in clinical laboratory is an objective method, but the results provided are not real-time. It is expensive, and there is significant interlaboratory and intralaboratory variability. Transcutaneous measurement of bilirubin concentration is considered to be ideal for neonatal jaundice screening. Transcutaneous readings are immediate, and they can indicate the need for total serum bilirubin testing. A number of factors such as gestational age, birth weight, skin color, phototherapy or degree of jaundice on accuracy of transcutaneous bilirubinometry require further study. We have been using Minolta Air-Shields Jaundice Meter 103 as a jaundice-screening device for term neonatal population since 2003
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