Comparison of Serum Bilirubin Level of Neonates Under Phototherapy with Two Methods of Transcutaneous and Total Serum Bilirubin Measurement

Objectives: To compare the serum bilirubin level of neonates under phototherapy with two methods of transcutaneous (TcB) and total serum bilirubin measurement (TSB). Methods: This descriptive-analytical study was conducted on the icteric term and late preterm neonates in Sabzevar, Iran between Oct 30, 2016, and Aug 7, 2018. Within 24 hours of birth, the TcB and then TSB of the neonates were measured before and after phototherapy. The TcB was performed using BiliCheck (KJ-8000 Transcutaneous Jaundice Meter) during phototherapy, at the forehead between the two eyebrows and the middle part of the sternum which were covered by a white 3 × 3 cm gauze. Results: 200 neonates were eligible, the bilirubin level of 50.5% of male infants were ranging from 15 to 18 mg/dL of serum. The correlation for serological-transcutaneous frontal tests was 0.74, 0.82, 0.76, and 0.55 for the first to the fourth day, respectively, versus to 0.71, 0.91, 92 0, and 0.69 for the mentioned days for serological-transcutaneous sternal tests. Based on Bland-Altman and intraclass correlation coefficient (ICC) methods for four days; although the correlation between the two methods is high on the first day in both areas, the value of reduction is greater on day four in the frontal area. Conclusions: Our findings revealed that the covering of sternal and frontal areas does not affect the correlation between the TcB and TSB methods. Also, TcB in the absence of TSB could be a good alternative in order to measure the level of bilirubin.