Abstract
BackgroundNeonatal hyperbilirubinemia, especially kernicterus, can be prevented by screening for neonatal jaundice. The transcutaneous bilirubin (TcB) meter is a non-invasive medical device for screening neonates. The study aimed to investigate the validity of a TcB meter in a resource-limited setting such as Mongolia.MethodsTerm and late preterm neonates from the National Center for Maternal and Child Health of Ulaanbaatar in Mongolia who met the inclusion criteria (gestational age ≥35 weeks, birth weight ≥2000 g, postnatal age ≤ 1 month) were enrolled in the study. We used a TcB meter, JM-103 to screen for neonatal jaundice. TcB measurements at the infant’s forehead and midsternum were performed within 3 h of obtaining samples for total serum bilirubin (TSB) measurement. We analyzed the correlation between TcB measurements and TSB measurements to validate the meter.ResultsA total of 47 term and six late preterm neonates were included in the study. TcB measured by the meter at both the forehead and the midsternum showed a strong correlation with TSB measured in the laboratory. The correlation equations were TSB = 1.409+0.8655 × TcB (R2=0.78871) at the forehead, and TSB = 0.7555+0.8974 × TcB (R2=0.78488) at the midsternum. Bland-Altman plots and the Bradley-Blackwood test showed no significant differences between the two methods at all measured ranges of bilirubin. The mean areas under the curves of TcB at the forehead and midsternum at three TSB levels (>10 mg/dL, >13 mg/dL, >15 mg/dL) of TcB were greater than 0.9, and all had high sensitivity and specificity.ConclusionsThis study established the validity of the JM-103 meter as a screening tool for neonatal jaundice in term and late preterm infants in Mongolia. Future studies are needed, including the establishment of a TcB hour-specific nomogram, for more effective clinical practice to prevent severe hyperbilirubinemia.
Highlights
Neonatal hyperbilirubinemia, especially kernicterus, can be prevented by screening for neonatal jaundice
The guidelines of the American Academy of Pediatrics (AAP) [1] indicate that transcutaneous bilirubin (TcB) measurements are accurate in the diagnosis of neonatal jaundice, and can reduce the need for blood sampling
They recommend that all neonates undergo total serum bilirubin (TSB) or TcB measurements at
Summary
Especially kernicterus, can be prevented by screening for neonatal jaundice. The transcutaneous bilirubin (TcB) meter is a non-invasive medical device for screening neonates. The guidelines of the American Academy of Pediatrics (AAP) [1] indicate that transcutaneous bilirubin (TcB) measurements are accurate in the diagnosis of neonatal jaundice, and can reduce the need for blood sampling. They recommend that all neonates undergo total serum bilirubin (TSB) or TcB measurements at Severe hyperbilirubinemia (kernicterus and, irreversible neurological sequelae) in newborns is preventable through appropriate follow-up, diagnosis, and treatment, such as phototherapy and exchange transfusions [2,3,4,5]. This diagnostic test was further validated among several ethnic groups in North America [11,12], Europe [13], and Asia [14,15]
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