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Defining the limitations of transcutaneous bilirubin measurement in late preterm newborns

Abstract

Objective:

The objective of this study is to determine the impact of postnatal age on the bias between transcutaneous (TcB) and total serum bilirubin (TSB), and evaluate a TcB screening protocol.

Study Design:

Preterm and term infants had paired TcB and TSB performed on days 1 to 3 of life; a subset of preterm infants had measurements on days 4 to 7. Sensitivity and specificity of TcB (plotted on an age-specific TSB nomogram) for prediction of high-intermediate (HIR) or high-risk TSB were calculated.

Results:

Median TcB bias was 2.6 and 2.5 mg dl−1 for term and preterm infants in the first 3 days of life, respectively. However, median bias was 2.2 mg dl−1 for preterm infants at 4 to 7 days of life. TcB in preterm infants predicted HIR or high-risk TSB with 94% sensitivity and 56% specificity.

Conclusion:

TcB screening protocols developed for term infants can be used for late preterm infants in the first 3 days of life.

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Correspondence to W J Cook.

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Fine, K., Carey, W., Schuster, J. et al. Defining the limitations of transcutaneous bilirubin measurement in late preterm newborns. J Perinatol 37, 658–661 (2017). https://doi.org/10.1038/jp.2017.8

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