Defining the limitations of transcutaneous bilirubin measurement in late preterm newborns

J Perinatol. 2017 Jun;37(6):658-661. doi: 10.1038/jp.2017.8. Epub 2017 Feb 16.

Abstract

Objective: The objective of this study is to determine the impact of postnatal age on the bias between transcutaneous (TcB) and total serum bilirubin (TSB), and evaluate a TcB screening protocol.

Study design: Preterm and term infants had paired TcB and TSB performed on days 1 to 3 of life; a subset of preterm infants had measurements on days 4 to 7. Sensitivity and specificity of TcB (plotted on an age-specific TSB nomogram) for prediction of high-intermediate (HIR) or high-risk TSB were calculated.

Results: Median TcB bias was 2.6 and 2.5 mg dl-1 for term and preterm infants in the first 3 days of life, respectively. However, median bias was 2.2 mg dl-1 for preterm infants at 4 to 7 days of life. TcB in preterm infants predicted HIR or high-risk TSB with 94% sensitivity and 56% specificity.

Conclusion: TcB screening protocols developed for term infants can be used for late preterm infants in the first 3 days of life.

Publication types

  • Comparative Study

MeSH terms

  • Bilirubin / blood*
  • Female
  • Humans
  • Hyperbilirubinemia, Neonatal / blood
  • Hyperbilirubinemia, Neonatal / diagnosis
  • Infant, Newborn
  • Infant, Premature / blood*
  • Jaundice, Neonatal / blood
  • Jaundice, Neonatal / diagnosis
  • Male
  • Minnesota
  • Neonatal Screening / methods*
  • Nomograms
  • Prospective Studies
  • Sensitivity and Specificity
  • Term Birth / blood*

Substances

  • Bilirubin