Transcutaneous bilirubinometry in neonatal intensive care units

To study the influence of several clinical and paraclinical factors on the association between jaundice meter readings and plasma bilirubin concentration; and to comment on the usefulness of the jaundice meter as a screening device for hyperbilirubinaemia in neonatal intensive care units.

Three hundred and seventy seven newborn babies admitted to the neonatal intensive care unit for various causes were included in the study. When the plasma bilirubin concentration needed to be determined for clinical reasons, the extent of the yellow skin colour was measured transcutaneously, using a jaundice meter. The haemoglobin concentration was also determined. This had no independent influence on the jaundice meter readings. The yellow skin colour was significantly and positively correlated with the bilirubin concentration and the presence of respiratory distress syndrome (RDS), and negatively with gestational age and postnatal ages.

These findings were interpreted as being due to variations in the ability of albumin to bind bilirubin, and in the basal yellow skin colour. It was impossible to derive simple criteria for detection of hyperbilirubinemia by jaundice meter readings in this study group.