Transcutaneous Bilirubin Assessment for Screening of Hyperbilirubinemia in Term and Near-Term Neonates with Jaundice, a Comparative Study

Abstract Background Neonatal hyperbilirubinemia is common in the neonatal period. Yet, serious pathological hyperbilirubinemia may cause kernicterus with detrimental neurologic sequalae. Carbon monoxide (CO) is the byproduct of the breakdown of heme, it is transported as carboxyhemoglobin to the lungs to be exhaled. Thus, carboxyhemoglobin levels increase as a result of hemolysis, and is therefore considered a sensitive index for the degree and severity of the subsequent hyperbilirubinemia. Objectives To correlate between non-invasive carboxyhemoglobin levels and bilirubin levels in near-term and tem neonates starting hour I of life. Subjects and methods A total of 100 near-term and term neonates were studied, by measuring carboxyhemoglobin by a Pulse CO-oximetry and serum bilirubin level (hour l) and transcutaneous bilirubin (TcB) hourly since birth for the I st 6 hours then every 6 hours till the time of discharge in a cross sectional case-control study. Results A cut off value of 4 for non-invasive carboxyhemoglobin with sensitivity of 81.25%, specificity of 95.24% was found to the earliest non-invasive predictor for subsequent jaundice. In patients with proven hemolysis, carboxyhemoglobin when compared to TcB was found to increase significantly in the first 3 hours of life more than TcB, stalting hour 4 till time of discharge it was increased yet statistically insignificant Conclusion We found that non-invasive carboxyhemoglobin is an effective early predictor for subsequent jaundice starting first hour of life. It can be used as a screening tool for hemolytic jaundice especially in hospitals with early discharge policy.

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Comparison of Two Transcutaneous Bilirubinometers in Term and Near-Term Neonates

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.33.3.138 ◽

2014 ◽

Vol 33 (3) ◽

pp. 138-142 ◽

Cited By ~ 3

Author(s):

Serdar Umit Sarici ◽

Esad Köklü ◽

Oguzhan Babacan

Keyword(s):

Newborn Infants ◽

Outcome Variable ◽

Term Neonates ◽

Transcutaneous Bilirubin ◽

New Device ◽

Term Newborn ◽

Main Outcome Variable ◽

Near Term ◽

Mean Differences

Purpose: Determination of bilirubin levels is performed for many newborns in the first days of life, and several different transcutaneous bilirubinometers are available. We aimed to determine whether transcutaneous bilirubin measurement, as performed using Jaundice Detector JH20-1C, a new device, correlates with Minolta/Hill-Rom Air-Shields Transcutaneous Jaundice Meter model JM-103.Design and Sample: The study was performed on term or near-term newborn infants who underwent transcutaneous bilirubin measurements as part of their normal care. The study group consisted of 585 newborn infants with gestational ages ranging from 35 to 42 weeks, coming from an uneventful pregnancy. In this prospective study, bilirubin concentrations were determined with two different transcutaneous bilirubinometers.Main Outcome Variable: In 585 infants, the correlation coefficient for Jaundice Detector JH20-1C versus Minolta Air-Shields Jaundice Meter model JM-103 was .965 (p < .0001). The mean (± standard deviation) difference between the Jaundice Detector JH20-1C versus Minolta Air-Shields Jaundice Meter model JM-103 was 0.26 ± 0.95 mg/dL. Results showed the Jaundice Detector JH20-1C to have an acceptable level of intradevice imprecision (r = .978, p < .0001, mean differences .0158 ± .871 mg/dL).Results: Jaundice Detector JH20-1C showed the good performances of intradevice and interdevice imprecision in comparison with Minolta/Hill-Rom Air-Shields Transcutaneous Jaundice Meter model JM-103. Jaundice Detector JH20-1C may be suitable for screening term or near-term newborn infants for jaundice in the well-baby nursery or maternity ward.

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Serum Unbound Bilirubin Versus Transcutaneous Bilirubin in Jaundiced Term Neonates

Benha Journal of Applied Sciences ◽

10.21608/bjas.2020.136371 ◽

2020 ◽

Vol 5 (4) ◽

pp. 1-4

Author(s):

M.A. ELBISHRY ◽

A.E. Elsadek ◽

E.G. Behiry ◽

M.A. Hasan

Keyword(s):

Term Neonates ◽

Transcutaneous Bilirubin ◽

Unbound Bilirubin

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Predictability of transcutaneous bilirubinometry in late preterm and term infants at risk for pathological hyperbilirubinemia

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200486 ◽

2020 ◽

pp. 1-7

Author(s):

E. Dianova ◽

J. Fogel ◽

R.P. Verma

Keyword(s):

At Risk ◽

Serum Bilirubin Level ◽

Late Preterm ◽

Term Infants ◽

Term Neonates ◽

Transcutaneous Bilirubin ◽

Immune Mediated ◽

Positive Direct ◽

Neonatal Population ◽

Transcutaneous Bilirubinometry

BACKGROUND: The aim was to assess the predictability of transcutaneous bilirubinometry in late preterm and term neonates at risk for pathological hyperbilirubinemia, and to identify the neonatal population in which transcutaneous bilirubin most accurately predicts serum bilirubin level (SB, mg/dl). METHODS: The correlations between transcutaneous bilirubin (TCB, mg/dl) and SB in different neonatal population subsets; and between ΔTSB (TCB-SB) and relevant neonatal variables and clinical groups were analyzed. RESULTS: TCB correlated with SB (r = 0.82, p < 0.05) in the cohort (n = 350) and in population subsets (r = 0.81–0.9, p < 0.001). Black infants with gestational age (GA) >35 weeks and chronological age (CA) >3 days recorded strongest correlation (r = 0.9, p < 0.001) followed by Blacks, and non-Black infants with CA >3 days and GA >35 weeks. ΔTSB was positive in Blacks, and in infants with CA <3 days, or with no phototherapy. ΔTSB was negative in non-Blacks, in infants with positive direct Coombs test (DC+) or those receiving phototherapy. Black race [beta (SE) = 1.3(0.33), p < 0.001] had positive, while CA [beta (SE) =−1.74 (0.36), p < 0.001], DC + status [beta (SE) =−0.72 (0.25), p = 0.004] and receipt of phototherapy [beta (SE) =−0.84 (0.21), p < 0.001] each had negative correlation with ΔTSB. ΔTSB for Blacks was >Whites, Hispanics and Asians. CONCLUSION: SB is best predicted by TCB in Black infants with CA over 3 days and GA over 35 weeks. Variability in SB estimation by TCB is race, CA and immune mediated hemolysis specific.

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Plotting Transcutaneous Bilirubin Measurements on Specific Transcutaneous Nomogram Results in Better Prediction of Significant Hyperbilirubinemia in Healthy Term and Near-Term Newborns: A Pilot Study

Neonatology ◽

10.1159/000358373 ◽

2014 ◽

Vol 105 (4) ◽

pp. 306-311 ◽

Cited By ~ 8

Author(s):

I. Mohamed ◽

A.C. Blanchard ◽

E. Delvin ◽

J. Cousineau ◽

A. Carceller

Keyword(s):

Pilot Study ◽

Transcutaneous Bilirubin ◽

Term Newborns ◽

Near Term

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A 6-Day-Old Newborn with Vomiting and Jaundice

International Journal of Integrative Pediatrics and Environmental Medicine ◽

10.36013/ijipem.v6i.88 ◽

2021 ◽

Vol 6 ◽

pp. 5-8

Author(s):

Nkechi Okotcha ◽

Abbie Biggers ◽

Jonathan Martin ◽

Raphael Mattamal

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Serum Bilirubin ◽

Severe Form ◽

Intestinal Malrotation ◽

Term Neonates ◽

Transcutaneous Bilirubin ◽

Bilirubin Encephalopathy

Sixty percent of term neonates and 80% of preterms have jaundice within the first week of life. Jaundice can be pathologic or physiologic, indirect, or direct. Indirect jaundice can be neurotoxic at high levels. In its most severe form, this presents as acute bilirubin encephalopathy or kernicterus. Screening for jaundice using a transcutaneous bilirubin check or serum bilirubin has contributed tremendously to the reduction of kernicterus, which ranges from 0.5-1.3/100,000 births. Often, the etiology is easy to decipher. Otherwise, it may be complicated when there are several factors contributing. We present a case of a 6-day-old with jaundice and vomiting who was suffering from intestinal malrotation and a urinary tract infection.

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Breast-Feeding Frequency During the First 24 Hours After Birth in Full-Term Neonates

PEDIATRICS ◽

10.1542/peds.86.2.171 ◽

1990 ◽

Vol 86 (2) ◽

pp. 171-175 ◽

Cited By ~ 1

Author(s):

Yoshitada Yamauchi ◽

Itsuro Yamanouchi

Keyword(s):

Weight Loss ◽

Breast Feeding ◽

Full Term ◽

Feeding Frequency ◽

Term Neonates ◽

Transcutaneous Bilirubin ◽

Factors Affecting ◽

Beneficial Effects ◽

Breast Fed ◽

Maximum Weight Loss

The relation between the frequency of breast-feeding and intake, weight loss, meconium passage, and bilirubin levels was studied in 140 healthy, full-term, breast-fed, Japanese neonates born vaginally without complications. Factors affecting the frequency of breast-feeding were also evaluated. Mothers nursed their neonates, on average, 4.3 ± 2.5 (SD) times (range 0 to 11) during the first 24 hours after birth, and this frequency increased significantly to 7.4 ± 3.9 times during the next 24 hours (P < .001). There was a significant correlation between the frequency of breast-feeding during the first and second 24 hours after birth (r = .69, P < .001). The frequency of breast-feeding during the first 24 hours correlated significantly with frequency of meconium passage (r = .37, P < .01), maximum weight loss (r = -.22, P < .05), breast milk intake on day 3 (r = .50, P < .01) and day 5 (r = .34, P < .05), transcutaneous bilirubin readings on day 6 (r = -.18, P < .05), and weight loss from birth to time of discharge (day 7) (r = -.32, P < .01). There was a strong dose-response relationship between feeding frequency and a decreased incidence of significant hyperbilirubinemia (transcutaneous bilirubin readings ≥23.5) on day 6. The time of birth also affected the frequency of breast-feeding during the first 24 hours. Neonates born between midnight and 6:00 AM were nursed more frequently than those born between 1:00 PM and midnight (5.1 ± 2.4 vs 3.9 ± 2.3 times, P < .05). The results demonstrate that frequent suckling in the first days of life has numerous beneficial effects on the breast-fed, full-term newborn.

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