Relationship of Transcutaneous Billirubin with Serum Billirubin in Neonates with Jaundice


  • Vivek Arora Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Sanjay Singla Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Poornima Sharma Department of Community Medicine, RNT Medical College, Udaipur, Rajasthan, India
  • Rameshwar Ninama Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Harimohan Koli Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India



Hyperbilirubinemia, Jaundice, Serum bilirubin, Transcutaneous bilirubin


Background: Neonatal hyperbilirubinemia is a common problem in neonates with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to the hospitals in the newborn period. Studies comparing the correlation between total serum bilirubin (SBR) and transcutaneous bilirubin (TcB) have yielded different results. So, we planned this study to find out relationship between TcB and SBR values.

Methods: A hospital based prospective study was done during March 2016 to September 2016, in which a total of 120 newborns including term and preterm who were admitted with neonatal jaundice in NICU, Maharana Bhupal Hospital, Udaipur, Rajasthan were assessed in terms of age, sex and weight and investigated for both TcB and SBR. The sample size was calculated at a confidence interval of 90% and allowable error of 15%.

Results: Out of total 120 study subjects, 59 (49%) were males and 61 (51%) were females, out of which 53 (44%) were preterm and 67 (56%) were term neonates. Mean TcB and SBR values at the time of admission has a mean difference of 2.52 mg/dl with a p-value <0.001 (significant) on the other hand TcB and SBR at 24 hr of admission has a mean difference of 1.57 with a p-value >0.001, which is non-significant. TcB and SBR at 48 and 72 hr of admission also has a mean difference which is also non- significant (p >0.001).

Conclusions: From present study, we conclude that there is no significant difference between TcB and SBR values at 24, 48 and 72 hrs after starting phototherapy. The values of TcB are equally reliable as SBR values. 


Jaundice and hyperbilirubinemia in the newborn. In: Kliegman RM, Stanton BF, St Geme JW et al, Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders;2012:603-12.

Porter ML, Dennis BL. Hyperbilirubinemia in Term Newborn. Am Fam Physic 2002;65:599-606.

Maisels MJ, Clifford K, Antle CE. Jaundice in the healthy newborn infant: a new approach to an old problem. Pediatr. 1988;81:505-11.

Kiviahan C, Jams EJ. The natural history of neonatal jaundice. Paediatr. 1984;74:364-70.

Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near term newborns. Pediatr. 1999;103:6-14.

Briscoe L, Clark S, Yoxall C. Can transcutaneouse bilirubinometry reduce the need for blood tests in jaundiced full term babies. Arch Dis Child Fetal Neonat. 2002;86(3):190-2.

Janjindamai W, Tansantiwong T. Accuracy of transcutaneous bilirubinometer estimates using Bilicheck in Thai neonates. J Med Assoc Thai. 2005;88(2):187-90.

Karon BS, Teske A, Santrach PJ, Cook WJ. Evaluation of bilicheck non-invasive bilirubin analyzer for prediction of serum bilirubin and risk of hyperbilirubinemia. Am J Clin Pathol. 2008;130(6):976-82.

American Academy of pediatrics, subcommittee on hyperbilirubinemia. management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatr. 2004;114(4):297-316.

Engle WD, Jackson GL, Sendelbach D, Manning D, Frawley WH. Assessment of a Transcutaneous Device in the Evaluation of Neonatal Hyperbilirubinemia in a Primarily Hispanic Population. Pediatr. 2002;110(11):61-7.

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

Rubaltelli FF, Gourley GR, Loskamp N, Modi N, Roth-Kleiner M, Sender A et al. Transcutaneous bilirubin measurement: A multicenter evaluation of a new device. Pediatr. 2001;107(6):1264-71.

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. 2002;91(2):203-11.






Original Research Articles