A Comparison of Transcutaneous and Total Serum Bilirubin in Newborn Hispanic Infants at 35 or More Weeks of Gestation

Abstract

Introduction: Transcutaneous bilirubin (TcB) measurement in newborns has been studied extensively in the non-Hispanic population, but its usefulness in the Hispanic population remains unclear. We evaluate the accuracy of TcB measurements in assessing jaundice in Hispanic neonates by using total serum bilirubin (TSB) measurements as the reference standard and determine the TcB level that can be used to identify neonates at risk for clinically significant jaundice (above the 95th percentile).Methods: A total of 192 Hispanic neonates were enrolled. TcB measurements were performed within 30 minutes of obtaining the TSB measurement. The linear relationship between TcB and TSB was measured by using the Pearson correlation coefficient (r). We calculated sensitivity, specificity, and positive and negative predictive values by using a TcB level above the 75th percentile to identify neonates with a TSB level above the 95th percentile.Results: TSB ranged from 1.7 to 13.9 mg/dL, with 62% falling below the 75th percentile. TcB correlated well with TSB in Hispanic neonates (r ‫؍‬ 0.87). A TcB level above the 75th percentile detected all infants with a TSB level above the 95th percentile, sensitivity 100%, and specificity 66%.

A Comparison between Transcutaneous and Total Serum Bilirubin in Healthy-term Greek Neonates with Clinical Jaundice

“…According to our local guidelines, total serum bilirubin (TSB) values have to be estimated in every newborn with yellow discoloration between the "nipple line and the umbilicus" or below, in order to safely decide a care plan. Measuring the TSB or the transcutaneous bilirubin (TcB) levels are both cited as acceptable ways to assess neonatal jaundice (Ip et al, 2004;Kolman et al, 2007). However, the determination of TSB levels is an invasive, stressful and time-consuming procedure.…”

“…However, the determination of TSB levels is an invasive, stressful and time-consuming procedure. On the contrary, available TcB measurement devices offer a time-effective and non-invasive method to estimate serum bilirubin levels (Kolman et al, 2007). Our study examined the accuracy of TcB measurements in clinically jaundiced healthyterm Greek newborns, using TSB as the reference standard, in order to re-evaluate our local guidelines on this topic.…”

Monte Carlo Modeling of Light Propagation in Neonatal Skin

“…A total of 5x10 4 photons were launched for each specified wavelength in order to simulate the diffuse reflectance with the adequate precision. This number of launched photons is more than one order of magnitude higher than the required typical number of photons (3000) for modelling the total diffuse reflectance from a turbid medium of specified optical properties (Wang & Jacques, 1992-1998.…”

“…This simulation code describes the transport of an infinitely narrow photon beam perpendicularly incident on the multi-layered medium. The response of a multi-layered tissue system, speaking in terms of the simulated quantities, due to this interaction is called the impulse response or Green's function (Wang & Jacques, 1992-1998. The reflectance, transmittance, photon absorption and fluence, are the physical quantities simulated with this code.…”

“…Two classical papers , Delcher, et al accessed April, 2007 contain the working principles of BiliCheck, presenting the basics underlying development of an optical fiber spectrometer for measurement of TcB levels in newborn infants. The working principle of this measurement accounts for variations in dermal scattering, melanin content and cutaneous blood content by using the spectrum of visible light 380-760 nm for a total of 221 spectral points (Kolman et al, 2007). This chapter reports on the use of Monte Carlo modeling to numerically simulate the diffuse reflectance spectrum of neonatal skin in the spectral region 400-700 nm.…”