Published: 2021-06-24

Correlation of transcutaneous bilirubin with total serum bilirubin in neonates with hyperbilirubinemia

Mohanram Venkatesan, Arulraj Russelian, Palpandi Velimuthu


Background: For determining hyperbilirubinemia in a neonate, clinical evaluation, serum bilirubin estimation and trans cutaneous bilirubin estimation are the modalities available. Transcutaneous bilirubinometry (TcB) is routinely used to monitor jaundice in term and near-term infants. Literature shows a positive correlation observed between TcB and total serum bilirubin (TSB). The present study was conducted determine the correlation of TcB with TSB in neonates with hyperbilirubinemia admitted at a tertiary care hospital, Chennai

Methods: A cross sectional study was conducted at a tertiary care hospital, Chennai where 350 neonates who have clinical jaundice and require estimation of serum bilirubin who are admitted to the tertiary care centre, Chennai during December 2020-March 2021 were included in the study. The ROCHE INTEGRA-e 411+ autoanalyzer was used to estimate TSB (mg/dl) using a modified diazo method. The Jaundice Meter JM-103 to measure TcB, (Manufactured by Draeger medical systems, Germany). Pearson corelation coefficient was used to find the correlation between the two variables. P<0.05 was considered to be statistically significant.

Results: Out of 350 neonates admitted to the tertiary care centre, term deliveries were 57.1% and pre term were 42.9%. 83.1% were in the age group of 3-7 days. The mean weight of the study population was 2.16±0.60 kg. In term babies, Pearson corelation between TSB and TcB shows a statistically significant positive correlation, r=0.90 with p≤0.0001. Among pre term babies, Pearson corelation between TSB and TcB shows a statistically significant positive correlation, r=0.96 with p≤0.0001.

Conclusions: This study's findings support the use of a TcB metre as a screening tool for clinically significant hyperbilirubinemia.


Transcutaneous bilirubin, Hyperbilirubinemia, Neonatal serum bilirubin

Full Text:



Ansong-Assoku B, Ankola PA. Neonatal Jaundice. In: StatPearls. Treasure Island (FL) StatPearls Publishing; 2021. Available at: Accessed on 01 May 2021.

Pan DH, Rivas Y. Jaundice: Newborn to Age 2 Months. Pediatr Rev. 2017;38(11):499-510.

Bhutani VK, Johnson LH, Keren R. Diagnosis and management of hyperbilirubinemia in the term neonate: for a safer first week. Pediatr Clin North Am. 2004;51(4):843-61.

Bhutani VK, Stark AR, Lazzeroni LC, Poland R, Gourley GR, Kazmierczak S et al. Initial Clinical Testing Evaluation and Risk Assessment for Universal Screening for Hyperbilirubinemia Study Group. Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy. J Pediatr. 2013;162(3):477-82.

Szabo P, Wolf M, Bucher HU, Haensse D, Fauchère JC, Arlettaz R. Assessment of jaundice in preterm neonates: comparison between clinical assessment, two transcutaneous bilirubinometers and serum bilirubin values. Acta Paediatr Oslo Nor. 2004;93(11):1491-5.

RiskinA, Tamir A, Kugelman A, Hemo M, Bader D. Is Visual Assessment of Jaundice Reliable as a Screening Tool to Detect Significant Neonatal Hyperbilirubinemia? J Pediatr. 2008;152(6):782-7.

Moyer VA, Ahn C, Sneed S. Accuracy of clinical judgment in neonatal jaundice. Arch Pediatr Adolesc Med. 2000;154(4):391-4.

Gourley GR, Bhutani VK, Johnson L, Kreamer B, Kosorok MR, Dalin C et al. Measurement of serum bilirubin in newborn infants: Common clinical laboratory methods versus HPLC. Pediatr Res. 1999;45:283A.

Ebbesen F, Rasmussen LM, Wimberley PD. A new transcutaneous bilirubinometer, Bili Check, used in the neonatal intensive care unit and the maternity ward. Acta Paediatr Oslo Nor. 2002;91(2):203-11.

Maisels MJ, Ostrea EM, Touch S, Clune SE, Cepeda E, Kring E et al. Evaluation of a New Transcutaneous Bilirubinometer. Pediatrics. 2004;113(6):1628-35.

Vinod K, Bhutani MD, Gourley GR, Adler S, Kreamer B, Dalin C et al. Non-invasive Measurement of Total Serum Bilirubin in a Multiracial Predischarge Newborn Population to Assess the Risk of Severe Hyperbilirubinemia. Pediatrics. 2000:106;e17.

Rubaltelli FF, Gourley GR, Loskamp N, Modi N, Roth-Kleiner M, Sender A et al. Transcutaneous bilirubin measurement: a multi-center evaluation of a new device. Pediatrics. 2001107(6):1264-71.