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Updated: Dec 14, 2025
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Transcutaneous bilirubinometry during and after phototherapy in preterm infants: a prospective observational study
Ali Ahmed Raba1,2, Anne O'Sullivan1, Jan Miletin1,2,3,4
1Paediatric and Newborn Medicine, Coombe Women and Infants University Hospital, Dublin, Ireland.
Objective:
To examine the accuracy of transcutaneous bilirubinometry (TCB) measurements during and after phototherapy (PT) in preterm infants.
Design:
Prospective observational cohort study.
Setting:
Level III neonatal centre.
Patients:
Preterm infants (from 23+0 to 36+6 weeks of gestation) born between June 2017 and May 2018 requiring PT.
Interventions:
TCB was measured from an exposed area of the skin (the sternum; TCBU) and the covered area of the skin under the nappy (the bony part of the upper outer quadrant of the buttock; TCBC) within an hour of obtaining total serum bilirubin (TSB).
Main Outcome Measures:
Correlation and agreement between TCB (TCBU and TCBC) and TSB during and after PT.
Results:
We have enrolled 196 preterm infants. There was a significant correlation between TSB and TCB during PT (r=0.72, 95% CI 0.66 to 0.77 in covered area; r=0.75, 95% CI 0.70 to 0.80 in uncovered area) and after PT (r=0.87, 95% CI 0.83 to 0.91). TCB underestimated TSB level during PT, with a mean TCBC-TSB difference of -25±43 (95% agreement limits of 62 to -112) and a mean TCBU-TSB difference of -48±46 (95% agreement limits of 45 to -140). The agreement between TCB and TSB after cessation of PT improved, with TCB underestimating TSB by a mean TCB-TSB difference of -10±31 (95% agreement limits of 52 to -72).
Conclusion:
TCB measurements correlated strongly with TSB levels during and after PT. However, there was a wide and clinically relevant disagreement between TCB and TSB measurements during the PT phase, improving significantly after PT.
