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Accuracy of transcutaneous bilirubin measurement in preterm low-birth-weight neonates

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Abstract

The objective of this study was to evaluate the correlation and agreement between transcutaneous and serum bilirubin among preterm low-birth-weight neonates. Neonates born at <35 weeks of gestation with birth weight <2,000 g were enrolled prospectively. Transcutaneous bilirubin (TcB) was measured at forehead, sternum, and abdomen at 24 ± 6 and 72 ± 12 h after birth and when icterus involved arms or legs (Kramer zone 4–5). Serum total bilirubin (STB) was measured by microbilimeter (STB-M) at all these time-points and by high-performance liquid chromatography (STB-H) at one randomly chosen time-point. A total of 1,619 observations were made in 256 neonates (median gestation, 34 weeks (IQR, 32–35), birth weight 1,522 ± 288 g). Overall there was excellent correlation and agreement between TcB and STB-M with TcB on forehead being most accurate (r = 0.84, mean difference, 0.3 ± 1.9 mg/dL) followed by TcB on abdomen (r = 0.73, mean difference, 1.5 ± 2.6 mg/dL) and sternum (r = 0.72, mean difference, 1.5 ± 2.6 mg/dL). TcB performed well at all three points of measurement with best correlations being observed at icterus level 4/5. Correlation between TcB and STB-H measured by high-performance liquid chromatography was less strong but significant (r = 0.59 to 0.69 at different time points of measurement). Conclusions: TcB has good correlation and agreement with STB in preterm low-birth-weight neonates born at ≥28 weeks of gestation.

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Abbreviations

HPLC:

High-performance liquid chromatography

LBW:

Low birth weight

STB:

Serum total bilirubin

STB-M:

Serum total bilirubin measured by microbilimeter

STB-H:

Serum total bilirubin measured by high-performance liquid chromatography

TcB:

Transcutaneous bilirubin

VLBW:

Very low birth weight

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Funding source

Study was funded by extramural research grant from Indian Council of Medical Research (IRIS ID, 2008–02250)

Financial disclosure

None of the authors have any financial relationships relevant to this article to disclose.

Conflict of interest

The authors declare that they have no conflict of interest. None of the authors have any financial relationship with the organization that sponsored the research.

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Authors and Affiliations

  1. Department of Pediatrics, Government Medical College Hospital, Chandigarh, 160 030, India

    Deepak Chawla, Suksham Jain & Vishal Guglani

  2. Department of Physiology, Government Medical College Hospital, Chandigarh, 160 030, India

    Gurjit Kaur & Vikas Sinhmar

Authors
  1. Deepak Chawla
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  2. Suksham Jain
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  3. Gurjit Kaur
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  4. Vikas Sinhmar
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  5. Vishal Guglani
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Corresponding author

Correspondence to Deepak Chawla.

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Chawla, D., Jain, S., Kaur, G. et al. Accuracy of transcutaneous bilirubin measurement in preterm low-birth-weight neonates. Eur J Pediatr 173, 173–179 (2014). https://doi.org/10.1007/s00431-013-2142-0

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  • DOI: https://doi.org/10.1007/s00431-013-2142-0

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