[Comparison of transcutaneous and serum bilirubin level in term neonates with jaundice]

ABSTRACT

Transcutaneous bilirubin measurement is a noninvasive method which is associated with decreased pain, less skin injury and lower risk of infection. In addition there is no need to take blood sample .The aim of this study was to determine the clinical accuracy of transcutaneous bilirubinometry [TCB] in comparison to that of total serum bilirubin [TSB] measurements in term neonates. This descriptive- analytic study included 212 term neonates with indirect hyperbilirubinemia at neonatal intensive care unit of Imam Reza Hospital in Kermanshah from January 2009 to August 2010. Inclusion criteria were birth weights between 2500-4000 grams and postnatal age between 2-28 days. Before starting phototherapy blood samples for measurement of serum bilirubin levels were obtained and measurement of transcutaneous bilirubin was carried out at the same time. Measurement of transcutaneous bilirubin from the forehead skin was performed by a trained person according to the manufacturer's recommendations. Data analysis was performed with Stata software. Mean values for total serum bilirubin before and after the onset of phototherapy were 18.43 and 15.21 mg/dl, and the respective values for transcutaneous bilirubin were 18.08 and 15.02mg/dl. There were no significant differences between transcutaneous and serum bilirubin levels before the onset of phototherapy [p=0.47], and the linear correlation coefficient was 0.50. Also no significant differences were detected between transcutaneous and serum bilirubin levels after phototherapy [p=0.27], and the correlation coefficient was 0.78. There was a good correlation between transcutaneous bilirubin and serum bilirubin levels especially in the male neonates with birth weights of less than 2600 grams after 12 hours of phototherapy. According to the results of this study, transcutaneous bilirubinometry can be recommended for the screening of neonatal jaundice