TRANSCUTANEOUS BILIRUBINOMETRY IN THE ASSESSMENT OF JAUNDICE IN TERM NEWBORNS AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU

Abstract

It is often necessary to monitor neonates for jaundice especially those discharged early from
health facilities. Measurement of serum bilirubin is invasive, painful and costly. Reliable
transcutaneous measurement of bilirubin should decrease the number of painful procedures,
reduce the volume of blood lost in phlebotomy, and reduce the need for hospital or
specialized clinic visits after discharge.
The objective of this study was to compare Transcutaneous Bilirubin (TcB) values
obtained using BiliChek® with Total Serum Bilirubin (TSB) in jaundiced term newborns as
well as determine the effect of postnatal age on the TcB values. This hospital based cross
sectional study was carried out between January and August 2014 at the University of Nigeria
Teaching Hospital, Enugu.
The study population consisted of 230 jaundiced term newborns aged 0 to 144hours.
The mean gestational age was 39.19 ±1.58 weeks, mean birthweight was 3.18 ± 0.42kg and
mean postnatal age was 81.36± 1.67hours. There were more males than females (1.07:1). The
mean TSB and TcB values were 10.48 ±2.18mg/dl and 10.84±2.79mg/dl respectively. The
mean difference of TSB and TcB levels (0.36mg/dl) was statistically significant. The TcB
levels were significantly higher than TSB levels across all the age categories. There was a
strong positive correlation between TSB and TcB levels in the jaundiced term newborns (r =
0.958, p < 0.001).
For TSB values, 52.6% of the newborns were classified as low risk; 19.6% as low
intermediate risk; 10.9% as high intermediate risk and 16.9% as high risk. For TcB values,
53.9% of the newborns were classified as low risk; 13.5% as low intermediate risk; 10% as
high intermediate risk and 22.6% as high risk. BiliChek® TcB produced the best predictive
ability at the low and high risk zones. Postnatal age had no significant effect on TcB values in
jaundiced term newborns across the age groups.
The findings of the present study showed that the BiliChek® is a reliable screening
tool for hyperbilirubinaemia in term newborns, especially those at high risk of developing
severe hyperbilirubinaemia. Hence TcB can be used to make clinical decisions on jaundiced
infants.

TRANSCUTANEOUS BILIRUBINOMETRY IN THE ASSESSMENT OF JAUNDICE IN TERM NEWBORNS AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU