title: Pre-Discharge Screening Trans-Cutaneous Bilirubinometry in Healthy Newborns in Mahdieh Hospital, Tehran.
abstract: BACKGROUND
  Incidence of jaundice is high in newborn infants. Since well appearing newborns are rapidly and routinely discharged from hospital, performing an inexpensive noninvasive pre-discharge screening test for evaluation of jaundice seems to be necessary.
  
  
  OBJECTIVE
  This study was conducted to compare the accuracy of cutaneous v/s serum bilirubin measurements in this regard.
  
  
  METHODS
  This was a prospective cross sectional study conducted in Mahdieh hospital, Tehran. 613 neonates weighing ≥ 1,800 g with gestational age of ≥ 35 weeks were enrolled. A pre discharge transcutaneous bilirubin test (TcB) was performed in all. Serum samples were taken from neonates with TcB ≥ 5 mg/dL in first and > 8 mg/dL in second 24 hours. Decision for treatment or recheck of bilirubin level after discharge was made based on serum bilirubin results.
  
  
  RESULTS
  Based on the study protocol, among 613 studied neonates, 491 (80%) revealed high TcB, of them 240 (49%) cases showed TBC ≥ 5 mg/dL in first and 251 (51 %) in second pre-discharge 24 hours. TcB ranged 3.3 - 17.1, mean TcB in first 24 hours was 6.9 ± 1 .7 (mode 6) and in second 24 hours 9.1 ± 2.1 (mode 10). Of 491 neonates with high TcB, capillary serum sample was taken as the second step and 398 neonates revealed high total serum bilirubin (TsB) with the same protocol for TcB. 108 (27.1%) neonates showed TsB ≥ 5 mg/dL in first and 290 (72.9%) in second 24 hours. According to the study results TcB has a 81% positive predictive value (PPV) in diagnosis of hyperbilirubinemia. Correlation coefficient of TcB and TsB in highest rate is equal to 72% (P value < 0.001).
  
  
  CONCLUSIONS
  TcB is an inexpensive, noninvasive and precise pre-discharge screening test for evaluation of hyperbilirubinemia, with a high PPV. It is highly recommended to be performed routinely due to high incidence of hyperbilirubinemia in neonates.
authors.affiliation: Neonatal Health Research Center (NHRC), Mofid Children's Hospital, Tehran, IR Iran ; Mahdieh Hospital, Tehran, IR Iran.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Afjeh
authors.affiliation: Neonatal Health Research Center (NHRC), Mofid Children's Hospital, Tehran, IR Iran ; Mahdieh Hospital, Tehran, IR Iran.
authors.forename: Minoo
authors.initials: M
authors.lastname: Fallahi
authors.affiliation: Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mehrnoosh
authors.initials: M
authors.lastname: Jahanbeen
authors.affiliation: Mahdieh Hospital, Tehran, IR Iran.
authors.forename: Azita
authors.initials: A
authors.lastname: Basiri
authors.affiliation: Blood Transfusion Research Center, High Institute for Research and Education in Transfusion, Tehran, IR Iran.
authors.forename: Mastaneh
authors.initials: M
authors.lastname: Allaee
keywords: Bilirubin; Hyperbilirubinemia; Predischarge Screening; TcB; Transcutaneous