Transcutaneous Bilirubinometry in Preterm and Term Newborn Infants before and during Phototherapy

Abstract

Introduction: To evaluate the accuracy of transcutaneous bilirubin measurement in a large population of newborn infants, before and during the phototherapy.

Patients and methods: A single Bilicheck instrument was used for transcutaneous measurements. A photo-opaque patch was positioned over the measurement site prior to starting phototherapy. Transcutaneous bilirubinometry was conducted on an unpatched area of the forehead skin and on the nearby site covered by the photo-opaque patch. Readings were obtained from patched and unpatched areas and simultaneous total serum bilirubin concentrations were compared.

Results: We studied 134 term and 36 preterm newborns. Pre-phototherapy measurements showed a strong correlation (r: 0.929, P < 0.001, Limit of agreement: -1.8 to 3.1) between Bilicheck and serum bilirubin readings. Post-phototherapy correlation between Bilicheck and serum bilirubin readings was (r: 0.921, P < 0.001, LOA: -1.8 to 2.8) among term and (r: 0.887, P = 0.001, LOA: -1.4 to 2.7) among preterm neonates in patched areas. These correlations were (r: 0.666, P < 0.001, LOA: -1.7 to 7.3) among term and (r: 0.756, P < 0.001, LOA: -0.5 to 5.3) preterm neonates post-phototherapy in unpatched areas.

Conclusion: BiliCheck can be safely used for the evaluation of bilirubin levels in preterm and term newborn infants under phototherapy. BiliCheck is slightly less reliable among preterm newborns.