Evaluation of transcutaneous bilirubinometry in preterm infants of gestational age 32-34 weeks

Abstract

Aims:The aim of this prospective study was to evaluate the accuracy of transcutaneous bilirubinometry using the Minolta Air-Shields JM-103 device in preterm newborns of gestational age 32-34 weeks, and to identify the most appropriate measurement site.Methods: Transcutaneous bilirubin (TcB) measurements were performed over forehead, sternum and abdomen, if total serum bilirubin (TSB) had to be determined on clinical indication in neonates of selected gestational age. TSB levels were measured in a clinical laboratory using direct spectrophotometry. In order to assess transcutaneous bilirubinometry accuracy, diff erences between TSB and TcB, their CI95%, and correlation coeffi cients (r) between TcB and TSB were evaluated.Results: The study group consisted of 44 infants, including 6 very low birth weight (VLBW) neonates. The correlations between transcutaneous and laboratory values were found to be signifi cant and close. Minimal diff erences were observed when measured over sternum. The measurements over forehead had a tendency to underestimate TSB levels.Conclusions: Noninvasive measurement by Minolta JM-103 demonstrated signifi cant accuracy. The authors recommend measurements over sternum or abdomen in premature infants born within 32-34 gestational weeks as a reliable and accurate neonatal hyperbilirubinemia screening test. Transcutaneous bilirubinometry has the potential to reduce the number of blood samplings, thus reducing neonatal pain and discomfort, parental distress and medical care cost.

Comparison of Transcutaneous Bilirubinometer Reading With Serum Bilirubin Level in Evaluating Jaundice in Newborn More Than 32 Weeks Gestation- A Diagnostic Test Evaluation

“…Skin is thinnest at forehead, which may be a reason for this significant correlation. This is in contrast to the above-mentioned study by Lucia Stillova et al, (13) which showed only a minimal difference of TCB values from forehead and mid sternum. Study done at Dept.…”

“…Present study showed a significant positive correlation between TSB and Transcutaneous values at the sternum ('r' value-0.669). A study performed by Lucia Stillova, Katarina Matasova et al in 2007, (13) observed minimal differences between TB and TCB measured over sternum. A study in Mongolian neonates (14) measured the TB with TCB (at forehead and mid sternum) showed a strong correlation (R 2 = 0.78871 and 0.78488, respectively).…”

Reliability of Transcutaneous Bilirubin Devices in Preterm Infants: A Systematic Review

“…Twenty-one studies 9,[20][21][22][23][24][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] provided results for correlation coefficients, and the pooled estimates according to the site of measurement were as follows: (Fig 2). There were no subgroup differences with respect to …”

“…Thirteen studies 20,21,23,25,26,[32][33][34][35][36][37]39,40 provided results as an analysis of the Bland-Altman difference plots. The studies were published between the years 2003 and 2012, and the majority used either JM-103 (6 studies) or BiliCheck (6 studies) devices except for the study by Karen et al, 26 which used Bilimed.…”

Evaluation of transcutaneous bilirubinometry in preterm neonates

“…1 The majority of earlier studies have examined the use of TcB in term and near-term neonates, [2][3][4][5][6][7] whereas studies that have been carried out in preterm neonates have yielded varying results. [8][9][10][11][12][13][14][15][16] Yasuda et al 17 reported that the correlation between TcB and TSB was similar in both preterm and term neonates. However, Namba and Kitajima 18 reported that accuracy and reliability of TcB versus TSB were diminished in neonates with birth weights <1000 g or gestational ages <28 weeks, compared with results in larger, more mature preterm neonates.…”