The Utility of Transcutaneous Bilirubin Measurement in Newborns with Hyperbilirubinemia: A Prospective, Observational Study during and after Phototherapy.

OBJECTIVE

This study aimed to evaluate the accuracy of transcutaneous bilirubin (TcB) measurements during and after phototherapy (PT) in term and late-preterm infants.

STUDY

DESIGN

In this prospective, observational study, TcB levels were measured at both the glabela (covered skin) and the lower abdomen (covered by the diaper) during treatment, then 12 and 24 hours after discontinuing the PT. Total serum bilirubin (TSB) levels were simultaneously collected through a blood sample. The agreement between TcB and TSB levels during and after PT was evaluated using Bland-Altman plots.

RESULTS

A total of 90 newborn infants and 540 paired bilirubin values were included in this study. The findings indicate that despite a moderate correlation with TSB levels, TcB measurements underestimate TSB levels.

CONCLUSION

This study indicates a moderate correlation and agreement between TcB measurements and TSB levels in term and late-preterm infants undergoing PT, with a tendency to underestimate TSB values and considerable variability between the two methods. Hence, TcB measurements cannot be relied upon as a substitute for TSB measurements during and after PT.

KEY POINTS: · TcB measurements show moderate correlation with TSB levels.. · Transcutaneous bilirubin measurements tend to underestimate total serum bilirubin levels, which may lead to potential undertreatment.. · Measurements from the lower abdomen are more practical for the evaluation of TcB.. · Transcutaneous bilirubin measurement is not a reliable substitute for total serum bilirubin levels in clinical settings during and after phototherapy.. · Further studies are needed to assess the accuracy of transcutaneous bilirubin measurements beyond 24 hours post-phototherapy..