Transcutaneous Bilirubin Meter; A POCT Device as a Screening Tool for Identifying Hyperbilirubinemia among Term Neonates

Introduction: Jaundice is observed during the first week of life in most of the newborns. Milder ones resolve spontaneously while severe ones need phototherapy or exchange transfusion. So, there is a need to screen all newborns for hyperbilirubinemia. Total serum bilirubin measured in the laboratory is the standard protocol followed but is invasive. Transcutaneous bilirubin, measured by a bilirubinometer, is emerging as a promising non-invasive tool. With this context, we evaluated Transcutaneous bilirubin as a screening tool for identifying hyperbilirubinemia among term neonates. Materials and methods: A cross-sectional observation study was conducted among 137 clinically icteric neonates using paired bilirubin measurements, one estimating bilirubin by standard laboratory method and the other measuring Transcutaneous bilirubin measured by a Bilirubinometer. Results: 137 neonates participated in the study. 61% were boys and 39% were girl babies. The mean gestational age was 37.28±1.7 weeks. The average birth weight of the study subjects was 2.7±0.3 kg. The mean bilirubin concentration measured by TCB was 9.07±3.6 and that estimated in the laboratory, TSB was 10.32±4.1. A strong linear statistically significant correlation r=0.849 with p<0.001 was observed between TSB and TCB. Bland Altman analysis revealed a difference of 1.25mg/dl between TSB and TCB with the majority of data points falling within ±1.96 times of SD indicating strong agreement between TSB and TCB. Conclusion: Strong correlation and agreement between TSB and TCB support the use of TCB as an effective screening tool for identifying hyperbilirubinemia among term neonates. Keywords Hyperbilirubinemia, Transcutaneous bilirubin, Total serum bilirubin, Term neonates, Screening tool, RESEA