title: Screening for Hyperbilirubinemia in Japanese Very Low Birthweight Infants Using Transcutaneous Bilirubinometry.
abstract: OBJECTIVE
  To assess the accuracy of transcutaneous bilirubin (TcB) measurements at 5 different body sites in Japanese very low birthweight (VLBW) infants and to determine a cut-off value of TcB to detect total serum/plasma bilirubin (TB) levels ≥10 mg/dL (171 μM).
  
  
  METHODS
  In a prospective multicenter study, 85 Japanese VLBW infants were enrolled from 5 neonatal intensive care units during the study period. A total of 383 blood samples from infants not receiving phototherapy or ≥24 hours postphototherapy were analyzed. TcB was measured at the forehead, sternum, upper back, lower abdomen, and waist within 1 hour of blood collection. Linear regression analysis and Bland-Altman plots were used to compare TcB values at each site with TB levels. The TcB cut-off value for detecting TB ≥10 mg/dL was determined by receiver operating characteristics curve analysis.
  
  
  RESULTS
  TcB significantly correlated with TB, but the coefficient of determination varied among the sites (forehead: 0.5294, sternum: 0.6488, upper back: 0.6321, lower abdomen: 0.5430, waist: 0.7396). At a TcB value ≥8, the sensitivity was 100% at the sternum and upper back, 85% at the waist, 84% at the forehead, and 64% at the lower abdomen to detect TB ≥10 mg/dL.
  
  
  CONCLUSIONS
  In Japanese VLBW infants, the accuracy of TcB measurements varies according to body site. TcB ≥8 on the sternum or upper back is more reliable than that on the forehead, lower abdomen, or waist to detect TB levels ≥10 mg/dL.
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurokawa
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Pediatrics, Kakogawa West Municipal Hospital, Kakogawa, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yokota
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Sota
authors.initials: S
authors.lastname: Iwatani
authors.affiliation: Department of Pediatrics, Kakogawa West Municipal Hospital, Kakogawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morisawa
authors.affiliation: Department of Pediatrics, Takatsuki General Hospital, Takatsuki, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Katayama
authors.affiliation: Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sakai
authors.affiliation: Department of Pediatrics, Japanese Red Cross Society Himeji Hospital, Himeji, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ioroi
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: ichim@med.kobe-u.ac.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Morioka
mesh_terms: D044466:Asian People; D001663:Bilirubin / Q000097:blood*; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D010789:Phototherapy; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity
chemical_list: D001663:Bilirubin