Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;29(1):43-54.
doi: 10.21315/mjms2022.29.1.5. Epub 2022 Feb 23.

Comparison between the Transcutaneous and Total Serum Bilirubin Measurement in Malay Neonates with Neonatal Jaundice

Mazrah Mohamed  1 , Nor Rosidah Ibrahim  1   2 , Noraida Ramli  1   2 , Noorizan Abdul Majid  1   2 , Najib Majdi Yacob  3 , Ariffin Nasir  1   2
Affiliations

Comparison between the Transcutaneous and Total Serum Bilirubin Measurement in Malay Neonates with Neonatal Jaundice

Mazrah Mohamed et al. Malays J Med Sci. 2022 Feb.

Abstract

Background: This study aims to investigate the reliability of the Dräger Jaundice Meter JM-105 for the screening of neonatal jaundice in Malay neonates.

Methods: A cross-sectional study was conducted in a university hospital involving 130 jaundiced neonates requiring serum bilirubin determination from day 2 to day 7 of life.

Results: The mean total serum bilirubin (TSB) was 232 μmol/L, whereas the mean transcutaneous bilirubin (TcB) measured at the forehead and sternum were 222 μmol/L and 223 μmol/L, respectively. Further, TcB underestimates TSB with a mean difference of 10.10 μmol/L at the forehead and 9.27 μmol/L at the sternum. A positive linear relationship was observed between TSB with TcB forehead (r = 0.82) and TcB sternum (r = 0.80). A good discriminations ability was observed for both the TcB forehead (receiver operating characteristics [ROC] curve = 89.8%) and sternum (ROC curve = 89.7%) at a TSB level of 205 μmol/L. The sensitivity ranges from 84.4% to 85.3%, while the specificity ranges from 77.4% to 76.4%.

Conclusion: Our study demonstrates a strong linear relationship and good diagnostic accuracy of TcB values compared to TSB values. To conclude, TcB measured at the forehead or sternum is a good alternative as a non-invasive screening tool for non-severe hyperbilirubinemia in Malay neonates.

Keywords: JM-105 bilirubinometer; neonatal jaundice; total serum bilirubin; transcutaneous bilirubin.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None.

Figures

Figure 1
Figure 1
Study flow chart
Figure 2
Figure 2
Linear regression plot for (A) TSB versus the forehead TcB, and (B) TSB versus the sternum TcB
Figure 3
Figure 3
Bland-Altman plot showing the difference and average of (A) the forehead TcB and sternum TcB, (B) sternum TcB and TSB, and (C) forehead TcB and sternum TcB
Figure 4
Figure 4
Comparison of the area under receiver operating characteristics (ROC) curve between the forehead TcB and sternum TcB at TSB level of 205 μmol/L
Figure 5
Figure 5
Characterisation of the difference between (A) the forehead TcB-TSB and (B) sternum TcB-TSB throughout the measurement range of TSB. The shaded area represents the 95% CI of the linear fit line
See this image and copyright information in PMC

References

    1. Bhutani VK, Zipursky A, Blencowe H, Khanna R, Sgro M, Ebbesen F, et al. Neonatal hyperbilirubinemia and rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatr Res. 2013;74(Suppl 1):86–100. doi: 10.1038/pr.2013.208. - DOI - PMC - PubMed
    1. Grupp-Phelan J, Taylor JA, Liu LL, Davis RL. Early newborn hospital discharge and readmission for mild and severe jaundice. Arch Pediatr Adolesc Med. 1999;153(12):1283–1288. doi: 10.1001/archpedi.153.12.1283. - DOI - PubMed
    1. Ministry of Health Malaysia. Clinical practice guidelines: management of neonatal jaundice. 2nd ed. Kuala Lumpur, Malaysia: Ministry of Health; 2014.
    1. Taylor JA, Burgos AE, Flaherman V, Chung EK, Simpson EA, Goyal NK, et al. Discrepancies between transcutaneous and serum bilirubin measurements. Pediatrics. 2015;135(2):224–231. doi: 10.1542/peds.2014-1919. - DOI - PMC - PubMed
    1. ASL W, Mat Daud S, Siao Hean T, Yao Mun C, Mohamed Kutty F. Management of neonatal jaundice in primary care. Malay Fam Physician. 2016;11(2–3):16–19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408871/ - PMC - PubMed

LinkOut - more resources