Diagnostic Accuracy of Transcutaneous Bilirubinometry for Estimation of Serum Bilirubin in Neonates With Physiological Jaundice: A Prospective Cross-Sectional Study From a Tertiary Care Teaching Hospital in Western India

Background: Neonatal jaundice is among the most common causes of neonatal hospitalization. Early and accurate assessment of bilirubin levels is essential to prevent severe hyperbilirubinemia and bilirubin-induced neurological dysfunction. Although total serum bilirubin (TSB) estimation is considered the gold standard, repeated blood sampling is invasive and painful. Transcutaneous bilirubinometry (TcB) offers a rapid, non-invasive alternative. Objectives: To assess the accuracy of transcutaneous bilirubinometry by comparing TcB measurements with TSB levels and to evaluate its usefulness in reducing invasive blood sampling among neonates admitted with physiological jaundice. Methods: A prospective analytical cross-sectional study was conducted in the Sick Neonatal Care Unit of GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat, India, from November 2022 to February 2024. A total of 440 late-preterm and term neonates with physiological jaundice were enrolled. TcB measurements were obtained using the Dräger JM-105 bilirubinometer and compared with simultaneously measured serum bilirubin levels. Statistical analysis included descriptive statistics and Pearson correlation analysis. Results: Among 440 neonates, 248 (56.4%) were male and 192 (43.6%) were female. Term neonates constituted 64.8% of the study population, while 35.2% were preterm. Significant hyperbilirubinemia was observed in 42 (9.5%) neonates. A very strong positive correlation was observed between TcB and TSB values (r = 0.99, p <0.01). Mean admission TcB and TSB values were 13.96 ± 0.15 mg/dL and 14.49 ± 0.15 mg/dL respectively. After phototherapy, TcB and TSB values decreased to 3.40 ± 0.06 mg/dL and 3.44 ± 0.05 mg/dL respectively. Conclusion: Transcutaneous bilirubinometry demonstrated excellent correlation with serum bilirubin estimation and may serve as a reliable screening and monitoring tool for neonatal hyperbilirubinemia.