Neonatal and early infantile jaundice: assessment by the use of the smartphone / 中国新生儿科杂志

ABSTRACT

Objective To assess the accuracy of automated image－based bilirubin ( AIB ) of newborns or early infants obtained using a smartphone application called BiliScan for Newborn Jaundice . Method Jaundiced neonates (gestational age≥35 weeks) and early infants (postnatal age≤60 days) from out－patient or in－patient of our hospital during November 2016 to September 2017 were prospectively included.The total serum bilirubin ( TSB ), transcutaneous bilirubin ( TcB ) and AIB on chest were completed simultaneously on hospitalization , pre phototherapy, 0 h and 12 ～24 h after cessation of phototherapy for in－patients, and after diagnosis of breast－feeding jaundice for out－patients participants.The AIB were all detected by smartphone with an application of BiliScan for Newborn Jaundice .Statistical analysis was performed by SPSS 20.0.Result A total of 296 sets of data were enrolled from 194 neonates or infants in this study.The accuracy of AIB was not inferior to the TcB (The difference between the mean of the absolute value of AIB －TSB and the absolute value of TcB －TSB was 0.77 mg/dl, 95% confidence interval were 0.63 ～0.91 mg/dl).These results of the subgroups from male and female term infants , postnatal age＞2 days and the value of TSB≤20 mg/dl were similar to the overall results.However, in the subgroup of TSB＞20 mg/dl, the accuracy of AIB was lower than that of TcB compared to TSB.There were good correlation (r＝0.824) and consistency (96.5% samples lay within the 95% limits of agreement ) between AIB and TSB.In the subgroup of 10 mg/dl ＜TSB≤20 mg/dl, the correlation and consistency between AIB and TSB were better than those of the subgroups of TSB ≤10 mg/dl and TSB ＞20 mg/dl. Furthermore, TSBs of 97.5% neonates were not beyond AIB plus 3.80 mg/dl.Conclusion When 10 mg/dl＜TSB≤20 mg/dl, the accuracy of AIB was not inferor to TcB , and the correlation and consistency between AIB and TSB were relatively superior.The application BiliScan for Newborn Jaundice was suitable for dynamic monitoring moderate jaundice of neonates and early infants at home.