A study to evaluate the levels of Transcutaneous Bilirubin (TcB) and Total Serum Bilirubin (TSB) Measurements in TermNeonates: A comparative study

Abstract

Introduction: Transcutaneous Bilirubinometry (TcB) is a simple method for estimating bilirubin levels in neonates. This method is non-invasive, quick, and painless. We aimed to compare serum and cutaneous bilirubin measurements in term neonates.Materials and Methods:In this descriptive cross-sectional study, 230 neonates with icterus and birth weights of at least 2,500 grams or more were studied. TcB was measured using a bilirubinometer three times on the forehead and mean levels were calculated. Then, during the subsequent 30 minutes blood samples were obtained and sent to the laboratory for determining the Total Serum Bilirubin (TSB) levels.Results:Of the 230 neonates, 124 (62%) were boys and 76 (38%) were girls, with aMean± SD (Standard Deviation) age of 5.3±4.5 to 5.1+3.5 days   (range:   1-22   days).   99%   of  the neonates were breastfed and 49(21.30%) neonates had a history of icterus. Most of the neonates were the first child (53.90%). Moreover, 32.60% were the second child, and 13.50% were the third child and the next. 12.17%,13.91%, 13.91%,60.43% of the neonates became icteric on days 1, 2, 3, and 4 or more of birth respectively. Most neonates with hyperbilirubinemia have B+ blood(53.90) group and then A+ blood group(34.78%) have the highest frequency in the study. O+ blood group in mothers of newborns with jaundice was the most common (53.04 %), and then B+ blood group have the highest frequency in the mothers (25.65%). The mean ± SD serum and cutaneous bilirubin levels were 18.70±5.33 and 17.75±4.26 mg/dl, respectively. A high correlation (0.84) was observed between TSB and TcB.Conclusion:There was a strong correlation between serum and transcutaneous bilirubin levels. As transcutaneous bilirubin estimation is non-invasive, it gives quick and reproducible results. So, this method has potential screening value especially in the high-risk neonates for early intervention.

Keywords:Neonatal icterus, Serum bilirubin, Transcutaneous bilirubin