Publication:

Accuracy and correlation of transcutaneous bilirubin with total serum bilirubin in preterm neonates born at 28-34 weeks of gestation during the first week of life

Background Transcutaneous bilirubin (TcB) measurement is a non-invasive method for screening neonatal hyperbilirubinemia and may reduce the need for repeated blood sampling. Although its accuracy has been well established in term and late preterm neonates, evidence in preterm infants remains limited. This study aimed to evaluate the correlation between TcB and total serum bilirubin (TSB) levels in preterm neonates born between 28 and 34 weeks of gestation during the first seven days of life.

Methods This prospective observational study included 100 preterm neonates (28-34 weeks' gestation) admitted to the neonatal intensive care unit of a tertiary care hospital over a two-year period. TcB was measured using the BiliCare™ device on the helix of the ear immediately before or within five minutes of blood sampling for TSB estimation. The correlation between TcB and TSB values was evaluated by using Spearman's and Pearson's correlation coefficients.

Results The mean gestational age was 31.4±1.97 weeks, and the mean birth weight was 1.56±0.35 kg. TcB and TSB mean values were 10.74±2.77 mg/dl and 10.16±3.59 mg/dl, respectively. It showed positive correlation between TcB and TSB (Spearman's rho=0.794, p<0.05; Pearson's correlation=0.870, p<0.05). The linear regression analysis showed the equation: TSB=1.6667×TcB-8.3333. This shows good predictive ability of TcB for serum bilirubin levels estimation.

Conclusions TcB measurement showed positive correlation with TSB in preterm neonates of 28-34 weeks' gestation before initiation of phototherapy. TcB is a reliable, non-invasive screening tool that may avoid the need for invasive blood sampling in neonates, while TSB estimation should continue to guide therapeutic decisions.