Measuring transcutaneous bilirubin: a comparative analysis of three devices on a multiracial population.
BACKGROUND
Hyperbilirubinemia can lead to potentially irreversible bilirubin-induced neurotoxicity. Transcutaneous bilirubin (TcB) determination has become a valuable aid in non invasive screening of neonatal jaundice.The aim of this study is to compare the performance of three most widespread transcutaneous bilirubinometers on a multiracial population of term and late pre-term neonates.


METHODS
Bilirubin concentration was determined using traditional photometric determination and transcutaneously with Bilicheck, BiliMed and JM-103, in random order.Total serum bilirubin (TSB) was determined over a wide concentration range (15,8-0,7 mg/dl) with a mean of 9,5 mg/dl. Related TcB values using Bilicheck (TcB-BC), BiliMed (TcB-BM), and JM-103 (TcB-JM) are reported in Table 1.


RESULTS
A multiracial population of 289 neonates was enrolled with a gestational age ranging from 35 to 41 weeks; birth weight ranging from 1800 to 4350 grams; hours of life ranging from 4 to 424. In the total study population correlation analysis using Pearson coefficients showed good results for Bilicheck (r = 0.86) and JM-103 (r = 0.85) but poor for BiliMed (r = 0,70). Similar results were found for the non-Caucasian neonates subgroup. Bilicheck and JM-103 had a greater area under the curve than BiliMed when TSB =14 mg/dl was chosen as a threshold value both for the total study population and the non-Caucasian subgroup.


CONCLUSIONS
Bilicheck and JM-103, but not BiliMed, are equally reliable screening tools for hyperbilirubinemia in our multiracial neonatal population.
Division of Neonatology, Department of Pediatrics, Università Federico II, Via Pansini 5, 80131, Napoli, Italy. raimondi@unina.it
Francesco
F
Raimondi
Silvia
S
Lama
Francesca
F
Landolfo
Maria
M
Sellitto
Angela Carla
AC
Borrelli
Rosalba
R
Maffucci
Paola
P
Milite
Letizia
L
Capasso
D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D044383:Black People; D001774:Blood Chemical Analysis / Q000295:instrumentation*; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D007231:Infant, Newborn; D007234:Infant, Premature; D007558:Italy; D016014:Linear Models; D008297:Male; D015997:Neonatal Screening / Q000295:instrumentation*; D012372:ROC Curve; D044465:White People
D015415:Biomarkers; D001663:Bilirubin