Accuracy of transcutaneous bilirubinometer in assessing jaundice in newborns in Indian context

Abstract

Background: Jaundice is a very common problem in newborns. Though measuring serum bilirubin is considered the gold standard method for estimating jaundice, Transcutaneous Bilirubin (TCB) measurement by TCB meter is now used in various centers. The accuracy of TCB meter is affected by many factors, skin colour being one of them. Aim: To analyze the accuracy of TCB meter in comparison to serum bilirubin for assessing jaundice in babies with different skin colours, in a tertiary care centre in South India. Methods: The study was performed in 200 babies in a medical college, in South India over a period of five months from august 2016 to December 2016. Term babies upto 7 th post natal day without any complications were analyzed. Babies were categorized based on their skin colour into 6 groups using the Fitz Patrick's colour scale. Jaundice was quantified in these babies by TCB meter and by measuring serum bilirubin at the same time and the values were compared. Results: Out of 200 babies, 6 babies were in group 2, 100 in group 3, 83 in group 4 and 11 in group 5. Though the Pearson correlation was linear in all the groups, it was lesser in the dark skinned babies. So we concluded that assessment of jaundice by TCB meter is not accurate in dark skinned babies. Hence serum bilirubin must be done in these babies before intervention. Conclusion: TCB is not accurate in assessing jaundice in dark skinned babies. Still it can be used as a valid screening tool.