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Updated: Jun 21, 2026

Biochemical Measurement of Neonatal Hypoxia
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The Utility of Transcutaneous Bilirubin Measurement in Newborns with Hyperbilirubinemia: A Prospective, Observational

Duygu Besnili Açar1, Seda Yilmaz Semerci2

  • 1Division of Neonatology, Department of Pediatrics, Istanbul Gaziosmanpasa Training and Research Hospital, Istanbul, Turkiye.

American Journal of Perinatology
|March 26, 2026
PubMed

Insights

Transcutaneous bilirubin (TcB) measurements show moderate accuracy but tend to underestimate total serum bilirubin (TSB) levels in infants receiving phototherapy. TcB should not replace TSB testing during or after treatment.

Area of Science:

  • Neonatal Medicine
  • Pediatric Phototherapy
  • Bilirubin Metabolism

Background:

  • Jaundice is common in newborns, requiring monitoring.
  • Phototherapy is a standard treatment for neonatal hyperbilirubinemia.
  • Accurate bilirubin measurement is crucial for effective treatment.

Purpose of the Study:

  • To assess the accuracy of transcutaneous bilirubin (TcB) measurements compared to total serum bilirubin (TSB) levels.
  • To evaluate TcB accuracy during and after phototherapy in term and late-preterm infants.

Main Methods:

  • Prospective observational study involving 90 infants.
  • Paired TcB (glabella and abdomen) and TSB measurements were collected.
  • Bland-Altman analysis evaluated agreement between TcB and TSB.

Main Results:

  • A moderate correlation was observed between TcB and TSB levels.
  • TcB measurements consistently underestimated TSB values.
  • Significant variability existed between TcB and TSB measurements.

Conclusions:

  • TcB measurements have moderate agreement with TSB but are unreliable during/after phototherapy.
  • TcB cannot substitute for TSB testing in this clinical context.
  • Clinical decisions regarding phototherapy should rely on TSB levels.
Abstract

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