Diagnostic accuracy of transcutaneous bilirubinometer devices compared with the total serum bilirubin measurement in preterm =35 weeks) very low birth weight neonates during the neonatal period up to 7 days of life
Introduction: Hyperbilirubinaemia is the commonest morbidity in preterm neonates, most of whom are of very low birthweight (VLBW =1500g) babies. Repeated blood sampling in preterm VLBW neonates not only causes pain but may lead to sepsis and anaemia. Transcutaneous measurement of bilirubin by a device called transcutaneous bilirubinometer (TcB) is an effective alternative tool to predict neonatal hyperbilirubinaemia in late preterm and term neonates, most of whom have birthweights >2000g. Objectives: To evaluate diagnostic accuracy of TcB devices in comparison to total serum bilirubin (TSB) measurements in VLBW neonates. Method: We evaluated 128 preterm neonates with gestational ages ranging from 28 to 35 weeks and birthweights =1500g till 7 days of post natal age. A total of 1003 TcB readings were taken, along with concurrent heel prick capillary samples, for laboratory measurement of TSB. For TcB, Drager JM 103 transcutaneous bilirubinometer was used and for TSB, Microlab's Easybil instrument was used. Coefficient of correlation (r) and BlandAltman plot were calculated to check correlation between TSB and TcB. Results: Total number of neonates was divided into 2 groups: i) =1000g and ii) 1001 1500g. Paired readings of TSB and TcB were taken before and after starting phototherapy. All the paired readings were analysed for correlation between TcB and TSB. Correlation co efficient (r) value for group i) was 0.87 and for group ii) was 0.89 (p<0.0001) Before and after starting phototherapy, readings were analysed separately to see the effect of _________________________________________ Government Medical College Baroda, India *Correspondence: nawaz78692@gmail.com https:/orcid.org/0000 0002 3140 891X (Received on 04 May 2019: Accepted after revision on 21 June 2019) The authors declare that there are no conflicts of interest Personal funding was used for the project. Open Access Article published under the Creative Commons Attribution CC BY License phototherapy on correlation between TcB and TSB. Correlation co efficient (r) values for paired readings before starting phototherapy were 0.97 0.90 respectively for both groups and for paired readings after starting phototherapy were 0.81 0.83 respectively for both groups. Conclusions: TcB measurements correlate significantly with TSB levels in early preterm neonates with VLBW. Phototherapy does not affect the correlation significantly. DOI: http:/dx.doi.org/10.4038/sljch.v49i1.8893