Accuracy of Transcutaneous Bilirubin at Multiple Sites in Comparison to Serum Bilirubin in Neonatal Jaundice

Abstract

Objective: To study accuracy of transcutaneous bilirubin at multiple sites in comparison to serum bilirubin in neonatal jaundice. Methods: Present cross sectional study included 361 neonates developing jaundice within 2 weeks of life. Transcutaneous bilirubinometer (model MBJ 20) was used to record TcB at following sites - forehead, sternum, upper thigh and sole (near heel). Corresponding serum bilirubin (SBR) level was obtained within 30 minutes of TcB reading. Results: Of 361 neonates, 6 were excluded due to insufficient data, there were 185 males, 170 females, 277 term, 78 preterm neonates and 103 low birth weight and 21 very low birth weight neonates. Majority (58.3%) were between 4-6 days of life. Though, all the sites correlated with SBR, forehead (FH) TcB best predicted SBR in both preterm and term neonates. Between FH TcB and SBR, correlation coefficient was 0.749 indicating a positive and significant correlation (p=0.000). We also found maximum agreement of 86.8% at 5mg/dl to 15mg/dl range between FH TCB and SBR values. The sensitivity of FH TcB was 81.40%, specificity 73.45%, positive predictive value 86.78% and negative predictive value was 64.84%. Conclusions: Forehead is the most ideal site for TcB measurement. The maximum agreement between FH TcB and SBR was in the 5mg/dl to 15 mg/dl range.