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

Abstract

Objectives: To assess the ability of transcutaneous bilirubinometer for prediction total serum bilirubin levels in newborn infants after hospital discharge.

Methods: Newborn 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.

Results: A 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.

Conclusion: The 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.

Keywords: Hyperbilirubinemia; Neonatal jaundice; Total serum bilirubin; Transcutaneous bilirubin.