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Transcutaneous bilirubinometry in Chinese, Malay and Indian infants
1Department of Paediatrics, National University of Singapore, Republic of Singapore.
Insights
Transcutaneous bilirubinometry (TcB) accurately correlates with plasma bilirubin levels in diverse infant populations. This non-invasive method offers a cost-effective screening tool for neonatal jaundice.
Area of Science:
- Neonatology
- Medical Physics
Background:
- Neonatal jaundice is a common condition requiring monitoring of bilirubin levels.
- Accurate and non-invasive methods for bilirubin assessment are crucial for early detection and management.
- Existing methods may involve invasive procedures, causing stress to infants and parents.
Purpose of the Study:
- To investigate the correlation between transcutaneous bilirubinometry (TcB) and plasma bilirubin concentrations.
- To evaluate the efficacy of TcB in different ethnic groups: Chinese, Malay, and Indian infants.
- To determine the clinical utility of TcB as a screening tool for neonatal jaundice.
Main Methods:
- Transcutaneous bilirubinometry (TcB) using the Minolta Airshields bilirubinometer was performed on the chest and forehead of full-term infants.
- Capillary blood samples were simultaneously collected for plasma bilirubin determination.
- Data from 253 Chinese, 169 Malay, and 120 Indian infants were analyzed.
Main Results:
- A good correlation was observed between TcB readings and plasma bilirubin concentrations across all ethnic groups (r = 0.73–0.86).
- Correlation remained strong when combined data were analyzed (r = 0.75–0.80).
- A cut-off of 200 µmol/L for TcB readings was suggested as a safer clinical indicator.
Conclusions:
- Transcutaneous bilirubinometry (TcB) is a reliable and non-invasive method for assessing bilirubin levels in term infants.
- TcB offers a cost-effective screening approach, reducing the need for invasive blood sampling.
- This method can alleviate physical and emotional stress for infants, parents, and healthcare providers.
Abstract:
The objective of this study was to investigate the correlation of transcutaneous bilirubinometry (TcB) and plasma bilirubin concentrations in full-term Chinese, Malay and Indian infants. TcB was performed with the Minolta Airshields bilirubinometer on Chinese, Malay and Indian fullterm infants. The readings were taken on the chest (sternum) and forehead (glabella) when capillary blood was sampled for bilirubin determination. Five hundred and forty TcB indices in 253 Chinese infants, 282 in 169 Malay infants, and 182 in 120 Indian infants were obtained over the sternum and forehead. A good correlation between the TcB indices and the bilirubin concentrations was observed in Chinese, Malay and Indian infants: r = 0.78 (chest), r = 0.73 (forehead); r = 0.86 (chest), r = 0.84 (forehead); and r = 0.84 (chest), r = 0.82 (forehead). The correlation was just as good when the combined values were evaluated together: r = 0.80 (chest) r = 0.75 (forehead). In Chinese infants, correlation at values below 250 mumol l-1 was significantly better than that at values over 250 mumol l-1 r = 0.80 versus r = -0.20, p < 0.00001 (chest), and r = 0.74 versus r = 0.07, p < 0.00001 (forehead). However, a safer cut-off point clinically would be 200 mumol l-1, since only relatively few higher bilirubin values were encountered when TcB indices were below 200 mumol l-1. The same pattern was noticed with the other two groups, and the combined group. Thus, TcB provides a non-invasive, cost-effective screening method for significant neonatal jaundice, sparing infants and parents physical and emotional stress, and medical and nursing personnel extra work and inconvenience.