ABSTRACT
Background: Jaundice is a very common neonatal problemand contributes a lot to the admission into neonatal care unitsand hospitals. Early estimation of TcB may help identifyingneonates with significant jaundice requiring serum bilirubinestimation. This may help avoiding unnecessary estimation ofserum bilirubin by invasive method in preterm and termneonates. TcB has been practised mostly in the whitepopulation and studies in the nonwhite population is relativelyscarce. In Bangladesh, estimation of TcB is a very newapproach and not in practice in most of the centres; andinvolves only term and near-term neonates sparing pretermones.Objective: To evaluate the correlation of transcutaneousbilirubin with serum bilirubin in term and preterm neonates withjaundice.Methods: This cross sectional study was conducted in thedepartment of Neonatology, Bangabandhu Sheikh MujibMedical University (BSMMU) from September 2015 to August2016. Jaundiced neonates ranging from 28 to 42 weeks ofgestation were studied. JM-103 device and DichlorophenylDiazonium method were used to measure TcB and TSBrespectively. TcB measurements were obtained over thesternum 30 minutes prior or after blood sampling for TSB.Pearson’s correlation coefficient and linear regression analysiswere used to determine the correlation between TcB and TSB.Bland-Altman plot was used to analyse the agreement betweenTcB and TSB. ROC curve was constructed both for term andpreterm infants to determine the best cut-off values with theirsensitivity and specificity.Results: A total of 148 paired TcB-TSB readings for 102jaundiced term and preterm infants were obtained. Correlationcoefficient in total population, term and preterm neonates were0.83, 0.92 and 0.69 respectively. Bland-Altman plot showedreasonable agreement in term newborns but not in pretermbabies. Overall best sensitivity and specificity of TcB in termneonates was 90% and 73%, and in preterm neonates 65%and 60% respectively. Area under the curve for TcB was 86%in term neonates, whereas it was 63% in preterm neonates.