Evaluation of transcutaneous bilirubinometry in term neonates at Lagos State University Teaching Hospital, Ikeja, Lagos

Abstract

Background: Serum bilirubin can be estimated using a technique that is real-time, noninvasive, painless, fast, and relatively inexpensive technique which is transcutaneous bilirubinometry (TcB). There is a paucity of published research data in Nigeria on TcB, and the aim of this study was to determine the correlation of TcB with total serum bilirubin (TSB) and in a group of term Nigerian neonates at Lagos State University Teaching Hospital (LASUTH) using the Konica Minolta JM-103. Materials and Methods: One hundred and fifty neonates were consecutively recruited at LASUTH, and detailed sociodemographic and clinical information was recorded with an interviewer-administered questionnaire. TcB readings were taken on the forehead, sternum, and abdomen of the calm neonate in a supine position, and blood samples for TSB estimation were drawn from a peripheral vein within 10 min of TcB measurement. Results: Eighty-nine (59.3%) neonates were male; 129 (86%) neonates were of 37–39 weeks' gestational age while 56 (37.3%) presented in the clinic after 48 h of life. Over 83% of the neonates had TcB values that were higher than TSB values, and the percentage of neonates with TSB values > 12 mg/dl was 45.2% compared with 56.8% obtained by TcB. The correlation of TcB with TSB using the Pearson's correlation was positive (r = 0.924). The mean error of TcB compared with the TSB level was independent of gender, gestational age, age at presentation, or birth weight. The measured bias by the Bland and Altman method was 0.97 mg/dl (95% confidence interval: 0.74–1.21) while imprecision was ± 2.96 mg/dl. The best correlation at the forehead was r = 0.928. Conclusion: Excellent correlation of TcB with TSB was obtained from this study, and it is envisaged that further researches will be carried out in dark skinned neonates and that the use of the JM-103 will be widely adopted as a screening tool in Nigeria.