The accuracy of transcutaneous bilirubinometer measurements to identify the hyperbilirubinemia in outpatient newborn population

Abstract

ObjectivesTo assess the ability of transcutaneous bilirubinometer for prediction total serum bilirubin levels in newborn infants after hospital discharge. MethodsNewborn infants requiring total serum bilirubin (TSB) level measurement during an outpatient follow-up visit were included into the study. Transcutaneous bilirubin (TcB) measurement was carried out using JH20-1C (Ningbo David, China) transcutaneous jaundice detector and total serum bilirubin was simultaneously determined by direct spectrophotometry. The agreement between paired TSB and TcB measurements were assessed by Bland-Altman plot and Deming regression analysis. Predictive indices were also identified in different TcB cut-off values for TSB levels of 222, 256 and 291 μmol/L. ResultsA total of 271 paired TcB and TSB measurements were obtained from 218 newborn infants. 40.2% had an age of above 7 days at measurement time. The mean difference (95% CI) between TcB and TSB values was −1.7 (−5.4 to 2.1) μmol/L. For TSB levels of at least 256 and 291 μmol/L, a TcB cut-off of 222 μmol/L shows sensitivity of 90.6% and 100%, respectively. It was also determined that 39.4% of TSB measurements could be avoided when using TcB cut-off value of 222 μmol/L. ConclusionThe measurement of TcB with JH20-1C seems to be a reliable screening method for hyperbilirubinemia in the outpatient population when used a TcB cut-off of 222 μmol/L. The use of transcutaneous bilirubinometer could reduce the number of invasive blood sampling for the determination serum bilirubin.