Comparison between transcutaneous bilirubinometry and total serum bilirubin measurements in preterm infants <35 weeks gestation

This version was published on 1 January 2010

Ann Clin Biochem 2010;47:72-77
© 2010 Association for Clinical Biochemistry


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Original Articles

M Ahmed1,
S Mostafa1,
G Fisher2 and
T M Reynolds3

1 Department of Paediatrics, Queen’s Hospital, Burton Upon Trent;
2 Department of Biochemistry, Queen’s Hospital, Burton Upon Trent;
3 Leicester Medical School, University of Leicester, Leicester, UK

Corresponding author: M Ahmed, Queen’s Hospital, Belvedere Rd., Burton-on-Trent, Staffordshire DE13 0RB, UK. Email: mansoor.ahmed{at}

Background: Neonatal hyperbilirubinaemia is a common treatable cause ofbrain injury. The treatment for this condition is phototherapy.The decision whether to use phototherapy is currently dependentupon serum bilirubin assay results. However, repeated bloodsampling is not only traumatic but may also be a cause of anaemiain neonates. We evaluated a transcutaneous bilirubin assay methodto determine whether it was suitable for routine use in preterminfants.

Methods: One hundred and eighty-three transcutaneous bilirubin measurementswere taken contemporaneously with blood samples for laboratorymeasurement of serum bilirubin. The study was carried out withinformed parental consent and approval by the local researchethics committee.

Results: The transcutaneous bilirubin method (BiliChek®) exhibiteda consistent positive bias compared with the laboratory bilirubinassay. Consequently, for a given detection rate, the transcutaneousmethod had a higher screen positive rate, i.e. more neonateswould be given phototherapy if transcutaneous bilirubin resultswere used to decide. There was a margin of safety in the transcutaneousbilirubin assay calibration.

Conclusion: The BiliChek transcutaneous bilirubin assay is a safe alternativeto laboratory bilirubin assay in deciding whether to give pretermneonates phototherapy.

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