Comparison of Transcutaneous Bilirubin With Total Serum Bilirubin in Preterm Neonates Receiving Phototherapy

Amruta Pendse, Bonny Jasani, Ruchi Nanavati, Nandkishor Shrikishanji Kabra

This paper was presented at the IAP Neonatology Chapter annual conference, 2015 and won the gold medal.

Abstract

Objective: Evidence has shown a correlation between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) in preterm neonates before initiating phototherapy (PT). However, there is limited data on the reliability of use of TcB after initiation of PT in preterm neonates. Hence, the objective of the study was to compare TcB with TSB levels in preterm neonates after the initiation of PT.

Design: This was a single-center correlational study.

Study setting and duration: The study was conducted in a tertiary care neonatal intensive care unit for 6 months.

Methods: Thirty preterm neonates (gestational age > 28 weeks) having clinically detectable jaundice were enrolled. Jaundice was confirmed with TcB and TSB levels before initiating PT. A small patch was applied over the sternum. TcB assessment was repeated at 6 to 12 hours after the initiation of PT on the shielded skin area along with simultaneous TSB estimation. Correlation coefficients of TcB and TSB were calculated using Pearson correlation and compared according to gestational age and postnatal age.

Results: TcB holds a correlation with TSB both before (r = 0.903, P = .0001) and after initiation of PT (r = 0 .918, P = .0001). Correlation was better in neonates of 28 to 32 weeks’ gestational age (r = 0.976) than those of > 32 weeks’ gestational age (r = 0.887). It was also better for neonates of postnatal age < 72 h (r = 0.962) than those of > 72 h (r = 0.826).

Conclusion: TcB correlates significantly with TSB at the patched sternal site after initiating PT in preterm neonates.

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