A CORRELATION STUDY BETWEEN TRANSCUTANEOUS BILIRUBIN AND TOTAL SERUM BILIRUBIN LEVELS AMONG NEONATES

ABHISHEK KUMAR SHARMA; KAPIL DHAWAN; MEENAL MAKKAR; RUCHIRA SHARMA

doi:10.22159/ajpcr.2022.v15i3.43963

Authors

ABHISHEK KUMAR SHARMA Department of Pediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India. https://orcid.org/0000-0002-2358-1923
KAPIL DHAWAN Department of Pediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
MEENAL MAKKAR Department of Dermatology, Guru Gobind Singh Medical College, Faridkot, Punjab, Rajasthan, India.
RUCHIRA SHARMA Department of Pharmacy, Swasthya Kalyan Homeopathic Medical College, Jaipur, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i3.43963

Keywords:

Neonatal jaundice, Transcutaneous bilirubin, Total serum bilirubin

Abstract

Objective: The availability of modern bilirubin meters that measure bilirubin concentration in dermal and subcutaneous tissues has made it possible to obtain serial, non-invasive (i.e., painless) TcB (transcutaneous bilirubin) measurements. However, concerns have been raised regarding the appropriateness of comparing these TcB values to serum bilirubin values. This study aims to find a correlation between transcutaneous bilirubin and total serum bilirubin.

Methods: Prospective analytic study carried out in NICU of Govt. RDBP Jaipuria Hospital. Newborn babies up to the 10th postnatal day of life with visually found jaundice had been enrolled in the study. TcB was measured over mid-sternum with Dräger JM 105™ device. Simultaneous total serum bilirubin (TSB) measurements had been done. Pearson’s correlation coefficient and Bland–Altman analysis had been done. ROC curves of mean TcB at different TSB level had been constructed.

Results: In the study, 120 babies had been included. A significant correlation was founded between TcB and TSB measured values. Pearson’s correlation coefficient was 0.892 (p<0.001). The average error in evaluating hyperbilirubinemia with TcB compared to TSB was 0.101, with limits of agreement between −3.73 and +3.55. The AUOC at three TSB levels (>10 mg/dl, >12 mg/dl, and >15 mg/dl) was 0.860, 0.892, and 0.849.

Conclusion: In our study, TcB measurements correlated well with TSB measurements and validated its use as a screening tool for the evaluation of jaundice in newborns.

Downloads

Download data is not yet available.

References

Thakre R. Neonatal hyperbilirubinemia. In: Parthsarathy A, Menon P, editors. IAP Textbook of Pediatrics. 5th ed. Gwalior: Jaypee Brothers; 2013. p. 48-51.

McDonagh AF, Lightner DA. Like a shriveled blood orange-bilirubin, jaundice, and phototherapy. Pediatrics 1985;75:443-55.

Broughton PM, Rossiter EJ, Warren CB, Goulis G, Lord PS. Effect of blue light on hyperbilirubinemia. Arch Dis Child 1965;40:666-71.

Hsia DY, Allen FH, Gellis SS, Diamond LK. Erythroblastosis fetalis. VIII. Studies of serum bilirubin in relation to Kernicterus. N Engl J Med 1952;247:668-71.

Ip S, Chung M, Kulig J, O’Brien R, Sege R, Glicken S. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297-316.

Rennie J, Burman-Roy S, Murphy MS. Guideline development group. BMJ 2010;340:c2409.

Mahajan G, Kaushal RK, Sankhyan N, Sharma RL, Nakra M. Transcutaneous bilirubinometer in assessment of neonatal jaundice in Northern India. Indian Pediatr 2005;42:41-5.

Surana AU, Patel S, Prasad R, Tilwani S, Saiyad A, Rathod M, et al. Comparison of transcutaneous bilirubin with serum bilirubin measurements in neonates at tertiary care center in western part of India. Int J Contemp Pediatr 2017;4:2349-3283.

Joshi SM, Likhar SK, Athavale AV, Shukla US. Factors affecting birth weight: A study in a secondary level hospital in the gas affected area of Bhopal. Natl J Commun Med 2013;4:570-3.

Kumar VS, Jeyaseelan L, Sebastian T, Regi A, Mathew J, Jose R. New birth weight reference standards customized to birth order and sex of babies from South India. BMC Preg Childbirth 2013;13:38.

Gera R, Mehta S. Changing trends of sex ratio at birth at tertiary hospitals of Rajasthan. Int J Sci Res 2018;7:275.

Kumar GV, Georgeen AJ, Viswanatha Kumar HM. Evaluation of neonatal morbidity and mortality in low birth weight babies in a tertiary Care Hospital. Res J Pharm Biol Chem Sci 2013;4:481-5.

Dhanker M, Rawat AK, Varun. Etiological factors associated with low birth weight new borns. In J Bas App Med Sci. 2013;3:44-48.

Patil SV, Shrikhande DY, Singh G, Giri PA. The pattern of neonatal mortality and morbidity in LBW neonates: A study from a tertiary care hospital in rural India. Int J Studs Res 2011;1:123-8.

Gupta MK, Kakkar M, Sethi C, Malhotra AK. Pattern of morbidity and mortality in LBW neonates: A study from Jaipur. J Evol Med Dent Sci 2014;3:1339-45.

Mahumud RA, Sultana M, Sarker AR. Distribution and determinants of low birth weight in developing countries. J Prev Med Public Health 2017;50:18-28.

UNICEF. Statistics for Child Survival. Neonatal Mortality. Changes and Progress. Every Child Alive-the Urgent Need to End Newborn Deaths; 2018. Available from: https://www.unicef.org/publications/ index_102640.html

Hesaraki M. A comparison of serum and transcutaneous methods for diagnosing neonatal hyperbilirubinemia. Int J Res Med Sci 2017;5:2887-9.

Campbell DM, Danayan KC, McGovern V, Cheema S, Stade B, Sgro M. Transcutaneous bilirubin measurement at the time of hospital discharge in a multi- ethnic newborn population. Paediatr Child Health 2011;16:141-5.

Maisels MJ, Ostrea EM, Touch S, Clune SE, Cepeda E, Kring E, et al. Evaluation of a New Transcutaneous bilirubin metre. Am Acad Pediatr 2004;113:1628-35.

Bental YA, Shiff Y, Dorsht N, Litig E, Tuval L, Mimouni FB. Bhutani-based nomograms to predict significant hyperbilirubinemia using transcutaneous measurements of bilirubin. Acta Paediatr 2009;98:1902-8.

Panburana J, Boonkasidach S, Rearkyal S. Accuracy of transcutaneous bilirubinometry compared to total serum bilirubin. J Med Assoc Thai 2010;93:81-6.

Akahira-Azuma M, Yonemoto N, Ganzorig B, Mori R, Hosokawa S, Matsushita T, et al. Validation of a Transcutaneous bilirubin meter in Mongolian neonates: Comparison with total serum bilirubin. BMC Pediatr 2013;13:151.

Holland L, Blick K. Implementing and validating transcutaneous bilirubin metre for neonates. Am J Clin Pathol 2009;132:555-61.

Ho EY, Lee SY, Chow CB, Chung JW. Bilicheck transcutaneous bilirubin meter: A screening tool for neonatal jaundice in Chinese population. Hong Kong Med J 2006;12:99-102.