Abstract

Aim: To study the correlation between serum bilirubin (TSB) and transcutaneous bilirubin (TcB) after phototherapy on an area kept covered during the phototherapy treatment in Indian brownish complexioned newborns, with an aim to reduce post-therapy blood sampling.

Till now, no difference is found between Caucasian and brownish newborns in response to phototherapy. Previously TcB and TSB value correlation studies were done in Caucasian population but in case of Indian brownish complexion babies these correlations were not studied. So, our endeavor is to assess these correlations to decrease needle pricks in newborn.

Methods: 100 Late preterm (>35 weeks gestational age) and term neonates requiring phototherapy for the first time were enrolled in this study. Pre and post phototherapy (after 24 hours of therapy), TcB was assessed for all babies over mid sternum and on forehead. TSB was also determined pre and post phototherapy. The point on mid sternum where TcB was assessed was patched (area of 2.5cm diameter) with photo-opaque material before starting of phototherapy. The decision to initiate and stop phototherapy was as per the AAP recommendations.

Results: Post-therapy, significant correlation between TcB at both patched and unpatched area with TSB was found but significance level was much higher (less no of outliers) for the patched area. Analysis showed, post-therapy TcB level on patched area <10.1mg/dl is a good indicator to stop phototherapy without a TSB.

Conclusion: Transcutaneous bilirubinometry over a shielded area can give a fair idea of the declining trend in bilirubin levels, to avoid pricking the babies for TSB prior to stopping phototherapy

Keywords: Neonatal jaundice; Phototherapy; Photo-opaque; Serum bilirubin; Transcutaneous bilirubinometry

Abbreviations: TSB: Total Serum Bilirubin; TcB: Transcutaneous Bilirubin; AAP: American Academy of Pediatrics; ROC: Receiver Operating characteristics