The relationship between skin transcutaneous bilirubin measurement and total serum bilirubin in very low birth weight preterm infants.
Keywords:
skin transcutaneous bilirubin measurement, total serum bilirubin, very low birth weight preterm infants, phototherapyAbstract
Total serum bilirubin measurement is a standard diagnostic tool for detecting jaundice in very low birth weight preterm infants; this method can cause pain. A transcutaneous bilirubinometer has been developed and introduced for screening hyperbilirubinemia.The reliability of transcutaneous bilirubin measurement in this group of infants remains inconclusive. This a cross-sectional study aimed to identify the correlation between transcutaneous bilirubin (TcB) and serum bilirubin (TsB) levels in 74 very low birth weight preterm infants who before phototherapy. Infants were measured their TcB using the JM-105® device within 30 minutes of total serum bilirubin measurement. The bilirubin levels from both methods were analyzed using Pearson correlation coefficient and Bland-Altman plot statistics. The findings showed that, the average bilirubin levels in the blood and skin on the chest and forehead were 6.50±1.74 mg/dL, 6.85±1.89 mg/dL, and 6.92±1.62 mg/dL, respectively. The correlation coefficients (r) between blood bilirubin levels and skin bilirubin levels on the chest and forehead were 0.50 and 0.62. The Bland-Altman plot revealed that most values were distributed within the mean ±2 standard deviations, with an average difference of -0.35±1.83 mg/dL, a limit of agreement between -3.94 and 3.24 mg/dL, and a 95% confidence interval (CI) of -0.77 to 0.08 for blood and chest skin bilirubin levels. For the forehead, the mean difference was -0.42±1.45 mg/dL, with a limit of agreement between -3.262 and 2.42 mg/dL, and a 95% CI of -0.76 to -0.08. This study indicated that the correlation between TcB and TsB in very low birth weight preterm infants before photography was moderate but there was sufficiently consistent for using transcutaneous bilirubin measurement for jaundice screening.
This non-invasive method does not require laboratory results, reduces the risk of infection, and avoids discomfort for infants. However, blood bilirubin measurement had remained necessary for diagnostic confirmation.
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