[Transcutaneous bilirubinometry useful in the determination of hyperbilirubinaemia in icteric neonates]

Abstract

Objective: To evaluate the usefulness of transcutaneous bilirubinometry in determining the need for phototherapy in neonates with hyperbilirubinaemia and to assess whether this technique may be used as an alternative to blood tests.

Design: Prospective, descriptive.

Method: Serum bilirubin and both midfrontal and midsternal transcutaneous bilirubin were measured in icteric neonates admitted to the neonatal ward of the Kennemer Gasthuis, Haarlem, The Netherlands, between 1 March and 31 December 2005. The Minolta JM-103 jaundice meter was used for transcutaneous assessment. Data were interpreted with the aid ofa scatter plot, a 2-by-2 table and receiver operating characteristics (ROC) curve.

Results: A total of 70 matched transcutaneous-serum bilirubin measurements were taken from 50 patients, 22 girls and 28 boys. The mean gestational age was 66 hours (range: 12-164) and the mean birth weight was 2766 grams (range: 1680-4600). The mean duration of maternal amenorrhoea was 36.2 weeks (range: 32-41.3). The coefficient of correlation between serum bilirubin and mean transcutaneous midfrontal and midsternal bilirubin was o.88 and 0.91, respectively. The negative predictive value of mean transcutaneous midfrontal and midsternal bilirubin measurement was 0.91 and 0.87, respectively, indicating that phototherapy would be correctly avoided in 91 and 87% of children, respectively. Based on the area under the ROC curve, the transcutaneous midfrontal bilirubin measurement was more reliable than the midsternal measurement.

Conclusion: Transcutaneous bilirubin measurement was useful in determining the need for phototherapy in neonates with hyperbilirubinaemia. Use of this non-invasive screening method may help to avoid unnecessary blood sampling in neonates.