The Comparison of Transcutaneous Bilirubin Measurement with Total Serum Bilirubin Levels in Preterm Neonates Receiving Phototherapy

Abstract

Background: Neonatal jaundice, characterized by elevated levels of bilirubin in the blood, is a common condition affecting approximately 60% of term and 80% of preterm newborns in the first week after birth. In recent years, transcutaneous bilirubin (TcB) measurement has emerged as a non-invasive alternative for monitoring bilirubin levels. TcB devices estimate bilirubin levels by measuring the yellow pigmentation of the skin, providing immediate results without the need for blood samples. While TcB has shown promise in term infants, its accuracy and reliability in preterm neonates, particularly those undergoing phototherapy, remain areas of active investigation.

Aim: To study of comparison of transcutaneous bilirubin measurement with total serum bilirubin levels in preterm neonates receiving phototherapy.

Method: This was a hospital based prospective observational study conducted in a level IIIA NICU in Shri Shishu Bhawan Hospital, Bilaspur which is a tertiary care hospital from June– 2022 to March– 2024. It includes all the preterm neonates >28 and <37 weeks gestation diagnosed with Neonatal Hyperbilirubinemia. For TSB estimation,1ml blood was collected by venipuncture and estimated by vander bergh reaction. The TcB was measured on ear pinna using BILICARE bilirubinometer. Student t test was applied to compare the mean difference b/w TSB and TCB on different parameters. A two tailed p value less than 0.05 (p<0.05) was considered as statistically significant. A Scatter plot was used to depict relationship between TCB and TSB.

Results: In present study, among very preterm, moderate preterm and late preterm, the mean difference b/w TCB & TSB was 2.59, 1.96, and 2.30 respectively (p = .04). Moreover, mean difference b/w TCB & TSB among those with and withpout ABO incompatibility was 2.34 and 2.26 respectively (p = 0.002). Further, the mean difference b/w TCB & TSB in neonates with and without sepsis was 2.16 and 2.39 respectively (p = 0.209).

Conclusion: TCB process can be a good substitute for the TSB approach, particularly when phototherapy is started for neonates with bilirubin levels between 6 and 8 mg/dL. After phototherapy, it is not a very accurate gadget, though. With the TCB technique being offered as a non-invasive, painless procedure that produces results quickly within a matter of seconds the BiliChek device can serve as a valuable screening tool for infants with hyperbilirubinemia.