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Updated: Feb 21, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Accuracy of transcutaneous bilirubinometry in the preterm infants: a comprehensive meta-analysis
Mohammad Hassan Shabuj1, Jesmin Hossain2, Sanjoy Dey1
1a Department of Neonatology , Bangabandhu Sheikh Mujib Medical University, Neonatology , Dhaka , Bangladesh.
Insights
Transcutaneous bilirubin (TcB) measurement accurately correlates with total serum bilirubin (TSB) in preterm infants. This non-invasive method is reliable for assessing hyperbilirubinemia risk in premature neonates.
Area of Science:
- Neonatal Medicine
- Pediatric Care
- Medical Diagnostics
Background:
- Transcutaneous bilirubin (TcB) measurement is standard for term infants, but its utility in preterm infants remains debated.
- Accurate bilirubin assessment is crucial for managing hyperbilirubinemia in vulnerable preterm neonates.
Purpose of the Study:
- To evaluate the accuracy and reliability of transcutaneous bilirubinometry in preterm infants.
- To synthesize existing data on the correlation between TcB and total serum bilirubin (TSB) in this population.
Main Methods:
- A systematic literature search was conducted across MEDLINE, Embase, and Cochrane Library databases (2000-2017).
- Studies comparing TcB and TSB in preterm infants before phototherapy were included, extracting correlation coefficients.
- Risk of bias was assessed using the QUADAS tool, with pooled correlation coefficients calculated via Fisher's z transformation.
Main Results:
- Twenty-eight studies were included, reporting TcB-TSB correlation coefficients.
- Combined forehead and sternal site measurements showed a pooled correlation coefficient (r) of 0.82 (random effect) and 0.803 (fixed effect).
- Forehead and sternal sites yielded comparable pooled correlations (r=0.82), as did the JM103 and Bilicheck devices (pooled r=0.83).
Conclusions:
- Transcutaneous bilirubin (TcB) measurement demonstrates a strong correlation with total serum bilirubin (TSB) in preterm infants.
- TcB is a reliable, non-invasive method for evaluating potential hyperbilirubinemia in preterm neonates.
- The use of TcB devices on both forehead and sternum sites is supported for preterm infants.
Background:
Transcutaneous bilirubin (TcB) measurement is widely used in term babies. But its effectiveness till debated in preterm infants. So, our objective was to pool data to see the accuracy of transcutaneous bilirubinometry in preterm infants.
Method:
MEDLINE, Embase, Cochrane Library database were searched from 2000 to July 2017. The included studies had compared TcB with total serum bilirubin (TSB) in preterm infants before phototherapy and data were presented as correlation coefficients. Data were extracted by two reviewers and checked for accuracy by the third reviewer. The risk bias assessments were done by an assessment quality assessment of diagnostic accuracy studies tool. Pooled correlation coefficient assed after Fisher's z transformation and then converted to r.
Results:
We included 28 studies; all those studies reported results as correlation coefficients. In combination of both sternal and forehead site measurement, our pooled estimates of r = 0.82 (95% CI: 0.78-0.85) in random effect and r = 0.803 (95% CI: 0.78-0.81) in fixed effect model. For separate sites of measurement of TcB pooled r for forehead and sternum were comparable, r = 0.82 (95% CI: 0.78-0.85), and pooled correlation coefficient for the two devices JM103 and Bilicheck the estimated pooled r were also comparable (Pooled r = 0.83).
Conclusion:
Our study found that TcB measurement is well related with TSB values and can represent a reliable method for evaluating preterm infants with possible hyperbilirubinemia. Our findings support the use of investigated devices at both forehead and sternum sites in preterm infants.
