Study of the effectiveness and accuracy of transcutaneous bilirubinometer in early diagnosis of neonatal hyperbilirubinemia in North India

Authors

  • Tanya Department of Pediatrics, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India https://orcid.org/0009-0006-9445-6608
  • Amandeep Department of Pediatrics, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
  • Jatinder Singh Department of Pediatrics, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
  • Deepa Grewal Department of Obstetrics and Gynaecology, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
  • Inderjeet S. Sandhu MMIMSR, Mullana, Ambala, Haryana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20260102

Keywords:

Hyperbilirubinemia, Non-invasive, Neonates, Neonatal jaundice, Transcutaneous bilirubinometer

Abstract

Background: Neonatal hyperbilirubinemia affects 60% of full-term and 80% of premature infants leading to jaundice when serum bilirubin levels reach 5 mg/dl. As the red blood cells undergo the process of lysis, it increases the levels of serum bilirubin. The standard criteria to measure the levels of total serum bilirubin is via taking a blood sample but in contrast to it transcutaneous bilirubin measurement offers non-invasive, rapid results, typically within a minute, for assessing bilirubin levels. To determine the accuracy and reliability of transcutaneous bilirubinometer.  Additionally, to investigate the capability of transcutaneous bilirubinometers in facilitating the early diagnosis of hyperbilirubinemia in preterm babies.

Methods: For this study newly, registered neonates were assessed for hyperbilirubinemia, with MBJ20 bilirubinometer on the forehead within 24 hours of life and following up the patients for serum bilirubin levels. We took 400 neonates late preterm and term. The babies who had readings of 6 or more than 6 mg/dl, were further evaluated by total serum bilirubin levels.

Results: In our study using the MBJ-20 transcutaneous bilirubinometer, the mean bilirubin concentration measured via TCB at the forehead was 8.75±2.27 mg/dl, compared to a mean TSB value of 12.28±2.33 mg/dl. A strong positive correlation was observed between TCB and TSB levels (r=0.86). Furthermore, the diagnostic performance of TCB was high, with an area under the ROC curve (AUC) of 89.9%. The sensitivity of TCB forehead ranges between 80.0%–93.5% and the specificity is between 63.5%–79.4%.

Conclusions: The data of our study arrived at a conclusion that the use of TCB is potentially safe and effective. Its measurements are reliable and accurate.

Metrics

Metrics Loading ...

References

Madubuike C, Ugochukwu EF, Ezeanosike O, Chukwuka J, Okpara H. Evaluation of MBJ20® Transcutaneous Bilirubinometer in the assessment of severity of neonatal jaundice. Int J Neonatal Screen. 2016;19;2(4):8. DOI: https://doi.org/10.3390/ijns2040008

Asaye S, Bekele M, Getachew A, Fufa D, Adugna T, Tadese E. Hyperbilirubinemia and associated factors among neonates admitted to the neonatal care unit in Jimma Medical Center. Clin Med Insights Pediatr. 2023;17:1155. DOI: https://doi.org/10.1177/11795565231193910

Ullah S, Rahman K, Hedayati M. Hyperbilirubinemia in neonates: Types, causes, clinical examinations, preventive measures and treatments: A narrative review. Iranian J Public Health. 2016;45(5):558–68.

Ansong-Assoku B, Shah SD, Adnan M, Ankola PA. Neonatal jaundice. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. Available at: https://www.ncbi.nlm.nih.gov. Accessed on 21 August 2025.

Karimzadeh P, Fallahi M, Kazemian M. Bilirubin induced encephalopathy. Iranian J Child Neurol. 2020;14(1):7–19.

Sanna S, Busonero F, Maschio A. Common variants in the SLCO1B3 locus are associated with bilirubin levels and unconjugated hyperbilirubinemia. Hum Mol Genet. 2009;18(14):2711–8. DOI: https://doi.org/10.1093/hmg/ddp203

Okwundu CI, Uthman OA, Suresh G, Smith J, Wiysonge CS, Bhutani VK. Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns. Cochrane Database Syst Rev. 2017;(5):12660. DOI: https://doi.org/10.1002/14651858.CD012660

Kumar D, Kumar D. A prospective comparison of serum and transcutaneous bilirubin in Indian neonates. J Pediatr Intensive Care. 2020;19;11(2):100-4. DOI: https://doi.org/10.1055/s-0040-1721067

Surana AU, Patel S, Prasad R, Tilwani S, Saiyad A, Rathod M. Comparison of transcutaneous bilirubin with serum bilirubin measurements in neonates at tertiary care center in western India. Int J Contemp Pediatr. 2017;4:1445-9. DOI: https://doi.org/10.18203/2349-3291.ijcp20172683

Kurnianto A, Bermawi H, Darmawanti A, Bahar E. Transcutaneous bilirubinometry to estimate total serum bilirubin in neonatal jaundice. Paediatr Indones. 2017;57(1):8. DOI: https://doi.org/10.14238/pi57.1.2017.8-11

Lam TSK, Tsui KL, Kam CW. Evaluation of point-of-care transcutaneous bilirubinometer in Chinese neonates at an accident and emergency department. Hong Kong Med J. 2008;14(3):56-60. DOI: https://doi.org/10.1177/102490790701400112

Badiee Z, Mohammadizadeh M, Shamee M. Diagnostic usefulness of transcutaneous bilirubinometry in very preterm newborns. Int J Prev Med. 2012;3(4):262-5.

Khajehei M, Chua SC, Gidaszewski B, Swain J. Comparing JM-105 and MBJ-20 transcutaneous bilirubinometers according to the area tested in ethnically diverse late-preterm and term neonates. J Perinat Neonatal Nurs. 2021;35(3):30-7. DOI: https://doi.org/10.1097/JPN.0000000000000555

Ajay M, Savitha MR. Correlation between transcutaneous bilirubin at multiple sites and serum bilirubin in neonatal hyperbilirubinemia. Indian J Med Spec. 2013;4:153.

Kosarat S, Khuwuthyakorn V. Accuracy of transcutaneous bilirubin measurement in term newborns. J Med Assoc Thai. 2013;96(2):172–7.

Chimhini GLT, Chimhuya S, Chikwasha V. Evaluation of transcutaneous bilirubinometer (Draeger JM 103) use in Zimbabwean newborn babies. Matern Heal Neonatol Perinatol. 2018;4(1):1–7. DOI: https://doi.org/10.1186/s40748-017-0070-0

Boo NY, Ishak S. Prediction of severe hyperbilirubinaemia using the BiliCheck transcutaneous bilirubinometer. J Paediatr Child Health. 2007;43(4):297–302. DOI: https://doi.org/10.1111/j.1440-1754.2007.01062.x

Rodríguez-Capote K, Kim K, Paes B, Turner D, Grey V. Clinical implication of the difference between transcutaneous bilirubinometry and total serum bilirubin for classification of newborns at risk of hyperbilirubinemia. Clin Biochem. 2009;42(3):176–9. DOI: https://doi.org/10.1016/j.clinbiochem.2008.09.108

Mohamed M, Ibrahim NR, Ramli N, Abdul Majid N, Yacob NM, Nasir A. Comparison between the transcutaneous and total serum bilirubin measurement in Malay neonates with neonatal jaundice. Malays J Med Sci. 2022;29(1):43-54. DOI: https://doi.org/10.21315/mjms2022.29.1.5

Alanezi H, Shatla E, Sreekumar P, Al Shelali M, El-Monshed AH, Altheeb M. Comparison of transcutaneous bilirubin measurements at the forehead and sternum in neonates. J Pediatr Health Care. 2025;9:875. DOI: https://doi.org/10.1016/j.pedhc.2025.09.004

Zhang E, Wu TJ, Hudak ML, Yan K, Teng RJ. Optimal site for applying transcutaneous bilirubinometer as an outpatient screening tool for neonatal jaundice: a comparison between the sternum and forehead. Front Pediatr. 2024;12:1446524. DOI: https://doi.org/10.3389/fped.2024.1446524

Downloads

Published

2026-01-27

How to Cite

Tanya, Amandeep, Singh, J., Grewal, D., & Sandhu, I. S. (2026). Study of the effectiveness and accuracy of transcutaneous bilirubinometer in early diagnosis of neonatal hyperbilirubinemia in North India. International Journal of Contemporary Pediatrics, 13(2), 289–295. https://doi.org/10.18203/2349-3291.ijcp20260102

Issue

Section

Original Research Articles