Comparison of Transcutaneous Bilirubin Measurements at the Forehead and Sternum in Neonates.

INTRODUCTION

Early detection of hyperbilirubinemia is critical in newborns. Transcutaneous bilirubin (TcB) devices offer a non-invasive alternative to total serum bilirubin (TSB) measurements for screening newborn jaundice. This study aimed to compare TcB measurements taken at the forehead and sternum in neonates and to determine which site more accurately reflects TSB.

METHOD: We conducted a prospective observational study of neonates at risk for hyperbilirubinemia.

RESULTS

TcB measurements at the sternum were significantly higher than those from the forehead (mean difference: 1.05 mg/dL, p < .001), with stronger correlation to TSB (r = 0.712 vs. r = 0.686 for forehead). Sternal TcB measurements demonstrated smaller bias and tighter limits of agreement with TSB. Although both sites had high sensitivity (>94%), specificity was low for both sites (19%-31%).

CONCLUSION

The sternum is the optimal anatomical site for TcB screening of neonatal jaundice in routine practice. However, confirmatory TSB testing remains essential when TcB values approach clinical intervention thresholds.