The written informed consent was obtained from parents or legal guardians of the neonates, involved in the study. Exclusion criteria were severely ill neonates, neonates with a lethal congenital malformation, and those who had neonatal jaundice, and had already been treated with phototherapy. They were born at more than 35 weeks of gestation, had a birth weight of more than 2 kg, and were aged between 2 days and 7 days. The study took place in a special care nursery for two months in 2018.Įligible neonates were clinically jaundiced and required serum bilirubin determination. This was a cross-sectional study conducted in a tertiary university hospital, the largest hospital in the northeastern part of Malaysia. #TSB MEANING MEASUREMENT SKIN#Since different levels of skin pigmentation may theoretically influence results, this study aims to investigate the reliability of a transcutaneous bilirubinometer (the Dräger Jaundice Meter JM-105) for the screening of neonatal jaundice in a predominantly Malay population. However, there were only limited studies done using transcutaneous bilirubinometer in our country ( 11). Some countries as India and Mongolia had, in fact, conducted studies to implement the transcutaneous bilirubinometer as the screening tool for neonatal jaundice in their rural populations as well as those lacking resources ( 9, 10). The American Academy of Paediatrics even recommends a pre-discharge evaluation of bilirubin levels by measuring TSB or TcB in all neonates ( 8). The good correlation between TSB and transcutaneous bilirubin (TcB) values has made the transcutaneous bilirubinometer a valuable screening tool for TSB in hyperbilirubinemia management worldwide ( 7, 8). Since then, numerous studies using various transcutaneous bilirubinometer devices have been conducted to prove its accuracy and sensitivity. The first transcutaneous bilirubinometer was introduced in the 1980s and the technologies related to the devices have evolved tremendously over the past few decades. It gives an immediate result, allowing the immediate initiation of therapy and reducing the burden borne by health care providers. The bilirubin is estimated by pressing a probe either to the neonatal forehead or sternum. In recent years, the transcutaneous bilirubinometer, which uses photometry to detect bilirubin levels, has been used as an alternative to estimate the bilirubin levels.Ī transcutaneous bilirubinometer is a portable, painless and non-invasive device. The turnaround time for bilirubin test results may delay the initiation of therapy for neonatal hyperbilirubinemia. To measure bilirubin levels, the total serum bilirubin (TSB) measured by the biochemical laboratory is still considered a gold standard, but it is invasive, requiring needle pricks that carry the risk for infection, and cause pain and stress to the neonates ( 4). Severe neonatal hyperbilirubinemia and its sequelae can be prevented with appropriate serum bilirubin monitoring and early treatment involving phototherapy or exchange blood transfusion. Kernicterus is associated with a high mortality rate and survivors usually suffer from complications such as athetoid cerebral palsy, high-frequency hearing loss and intellectual disability ( 3). Most cases are benign, but severe neonatal hyperbilirubinemia can lead to bilirubin encephalopathy (kernicterus). It is occurs due to hyperbilirubinemia ( 1, 2). Neonatal jaundice is one of the commonest causes of hospital admission during the first week after birth.
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