A PROSPECTIVE COHORT STUDY TO DETERMINE CORRELATION BETWEEN TRANSCUTANEOUS BILIRUBIN AND SERUM BILIRUBIN VALUES IN NEONATES WITH HYPERBILIRUBINEMIA IN A TERTIARY CARE HOSPITAL

Abstract

Introduction: Hyperbilirubinemia is a major health condition seen in approximately 60% of term and 80% preterm neonates. Total serum bilirubin (TSB) estimation is the gold standard method and is the most common reason of blood drawing in neonates. Non-invasive method like transcutaneous bilirubin (TCB) estimation is an alternative for bilirubin estimation. Thus, the primary aim of present study is to compare the efficacy of the two methods. Th Methods: is prospective observational study was conducted between 2020-2022 on 836 neonates (>35 weeks, ≥2000gm) at Mazumdar Shaw Medical Centre, Narayana health city, Bangalore aimed to compare TSB and transcutaneous bilirubin (TCB) values using JM-105 bilirubinometer assessed TCB values taken before, during and phototherapy from covered and uncovered skin of different sites and correlated with the serum bilirubin values, through linear regression and Bland Altman analysis. Positive correlations were observed between TSB and TCB values at the forehead, st Results: ernum, and pubic symphysis, with the strongest correlation at the forehead (r-0.826, p<0.001) pre-phototherapy. Correlation weakened during and after phototherapy, notably at the forehead post-phototherapy (r-0.121, p>0.05). The preferred TCB estimation site was forehead pre- and 12 hours post-phototherapy with mean difference of 2.15±2.1 mg/dl and 0.6±2.13 mg/dl respectively, while sternum was favored site at 24 hours post-phototherapy; with mean difference of 2.01±2.32 mg/dl.TCB cut-off values (13.75mg/dl) demonstrated sensitivity (78.5%) and specificity (64.5%) for discontinuing phototherapy (ROC AUC 0.774, p<0.05). TCB proves effective as a non-invasive screenin Conclusion: g tool for bilirubin estimation, alleviating the need for repeated blood draws. However, caution is advised regarding TCB's reliability during phototherapy monitoring. The study provides valuable insights into TCB's clinical applicability, offering practical recommendations for optimal usage.