Volume : 12, Issue : 6, JUN 2026

DIAGNOSTIC ACCURACY OF TRANSCUTANEOUS BILIRUBINOMETRY FOR ESTIMATION OF SERUM BILIRUBIN IN NEONATES WITH PHYSIOLOGICAL JAUNDICE: A PROSPECTIVE CROSS-SECTIONAL STUDY FROM A TERTIARY CARE TEACHING HOSPITAL IN WESTERN INDIA

DR. HEMALATA PATIDAR

Abstract

Background: Neonatal jaundice is among the most common causes of neonatal hospitalization. Early and accurate assessment of bilirubin levels is essential to prevent severe hyperbilirubinemia and bilirubin-induced neurological dysfunction. Although total serum bilirubin (TSB) estimation is considered the gold standard, repeated blood sampling is invasive and painful. Transcutaneous bilirubinometry (TcB) offers a rapid, non-invasive alternative.

Objectives: To assess the accuracy of transcutaneous bilirubinometry by comparing TcB measurements with TSB levels and to evaluate its usefulness in reducing invasive blood sampling among neonates admitted with physiological jaundice.

Methods: A prospective analytical cross-sectional study was conducted in the Sick Neonatal Care Unit of GMERS Medical College and Civil Hospital, Gandhinagar, Gujarat, India, from November 2022 to February 2024. A total of 440 late-preterm and term neonates with physiological jaundice were enrolled. TcB measurements were obtained using the Dräger JM-105 bilirubinometer and compared with simultaneously measured serum bilirubin levels. Statistical analysis included descriptive statistics and Pearson correlation analysis.

Results: Among 440 neonates, 248 (56.4%) were male and 192 (43.6%) were female. Term neonates constituted 64.8% of the study population, while 35.2% were preterm. Significant hyperbilirubinemia was observed in 42 (9.5%) neonates. A very strong positive correlation was observed between TcB and TSB values (r = 0.99, p <0.01). Mean admission TcB and TSB values were 13.96 ± 0.15 mg/dL and 14.49 ± 0.15 mg/dL respectively. After phototherapy, TcB and TSB values decreased to 3.40 ± 0.06 mg/dL and 3.44 ± 0.05 mg/dL respectively.

Conclusion: Transcutaneous bilirubinometry demonstrated excellent correlation with serum bilirubin estimation and may serve as a reliable screening and monitoring tool for neonatal hyperbilirubinemia.

Keywords

NEONATAL JAUNDICE, HYPERBILIRUBINEMIA, TRANSCUTANEOUS BILIRUBINOMETER, TOTAL SERUM BILIRUBIN, DRÄGER JM-105, NEONATE.

Article : Download PDF

Cite This Article

IESRJ

International Educational Scientific Research Journal

E-ISSN: 2455-295X

International Indexed Journal | Multi-Disciplinary Refereed Research Journal

ISSN: 2455-295X

Peer-Reviewed Journal - Equivalent to UGC Approved Journal

Peer-Reviewed Journal

Article No : 8

Number of Downloads : 107

References

1. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Pediatrics. 2022;150:e2022058859.

2. Bhutani VK, Johnson LH. Kernicterus in the 21st century. Pediatrics. 2004;114:297-316.

3. Okwundu CI, et al. Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns. Cochrane Database Syst Rev. 2023.

4. Bhat JA, et al. Correlation of transcutaneous bilirubin with serum bilirubin during phototherapy. Int J Contemp Pediatr. 2020.

5. Mendoza-Chuctaya G, et al. Accuracy of transcutaneous bilirubin measurements in newborns. Children. 2021.

6. Ng Y, et al. Cost-effectiveness of transcutaneous bilirubin screening in NICU. J Perinatol. 2023.

7. Ohishi A, et al. Accuracy of JM-105 bilirubinometer. Pediatr Int. 2023.

8. Hansen TW. The epidemiology of neonatal jaundice. Pediatric Medicine. 2021;5(18):18-.

9. Allam JB, Kumar S, Kurmi R, Ara R, Kumar AM. First day serum bilirubin level, as predictor of significant hyperbilirubinemia in neonates. Archives of Medicine and Health Sciences. 2018 Jul 1;6(2):218-22.

10. Kramer LI. Advancement of dermal icterus in the jaundiced newborn. Am J Dis Child 1969;118:454?8.

11. Hulzebos CV, Vitek L, Coda Zabetta CD, Dvo?ák A, Schenk P, van der Hagen EA, Cobbaert C, Tiribelli C. Screening methods for neonatal hyperbilirubinemia: benefits, limitations, requirements, and novel developments. Pediatric research. 2021 Aug;90(2):272-6.

12. Narwal V, Batra B, Kalra V, Jalandra R, Ahlawat J, Hooda R, Sharma M, Rana JS. Bilirubin detection by different methods: A review. Sensing and Bio-Sensing Research. 2021 Aug 1;33:100436.

13. Chawla D, Jain S, Kaur G, Sinhmar V, Guglani V. Accuracy of transcutaneous bilirubin measurement in preterm low-birth-weight neonates. European journal of pediatrics. 2014 Feb;173:173-9.

14. Hynes S, Moore Z, Patton D, O'Connor T, Nugent L. Accuracy of transcutaneous bilirubin versus serum bilirubin measurement in preterm infants receiving phototherapy: a systematic review. Advances in Neonatal Care. 2020 Dec 1;20(6):E118-26.

15. Rizvi MR, Alaskar FM, Albaradie RS, Rizvi NF, Al-Abdulwahab K. A novel non-invasive technique of measuring bilirubin levels using bilicapture. Oman medical journal. 2019 Jan;34(1):26.

16. Kalakonda, Aditya, Bianca A. Jenkins, and Savio John. "Physiology, bilirubin." 2017.

17. Ives NK, Gardner RM. Blood-brain barrier permeability to bilirubin in the rat: studies using intracarotid bolus injection and in situ brain perfusion techniques. Pediatr Res 1990;27:436.

18. Ansong-Assoku B, Shah S, Adnan M, Ankola P. Neonatal jaundice. StatPearls. 2024 Feb 12.

19. Hansen TW. The epidemiology of neonatal jaundice. Pediatric Medicine. 2021;5(18):18-.

20. Boskabadi H, Sezavar M, Zakerihamidi M. Evaluation of neonatal jaundice based on the severity of hyperbilirubinemia. Journal of Clinical Neonatology. 2020 Jan 1;9(1):46-51.

21. Moyer VA, Ahn C, Sneed S. Accuracy of clinical judgment in neonatal jaundice. Arch PediatrAdolesc Med 2000;154:391-394

22. Okwundu CI, Uthman OA, Suresh G, Smith J, Wiysonge CS, Bhutani VK. Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns. Cochrane Database Syst Rev. 2017 May 17;2017(5):CD012660.

23. AmericanAcademy of Pediatrics, Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114(1):297–316.

24. Okwundu, Charles I. "Transcutaneous bilirubin screening for hyperbilirubinemia in African newborns." PhD diss., Stellenbosch: Stellenbosch University, 2019.

25.  Okwundu CI, Olowoyeye A, Uthman OA, Smith J, Wiysonge CS, Bhutani VK, Fiander M, Gautham KS. Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns. Cochrane database of systematic reviews. 2023(5).