A Prospective Comparison of Serum Versus Transcutaneous Bilirubin During Phototherapy in Neonates

Background: – Transcutaneous bilirubin (TCB) measurement provides a non-invasive way to assess bilirubin levels in newborns. While it aids in monitoring neonatal jaundice, its accuracy compared to total serum bilirubin (TSB), the gold standard, may differ based on measurement timing and phototherapy use. Purpose: – To evaluate the accuracy of the JM-105 TCB device by comparing it with TSB levels in term neonates before, during, and after PT. Methods: – A prospective single-center study of 150 healthy term neonates requiring PT. Transcutaneous bilirubin was measured using JM-105 on the mid-forehead and compared to TSB before PT, during treatment, and at 12 and 24 hours after treatment. Skin tone differences were also analyzed. Results: – The study population consisted of 52% males with an average gestational age of 38.9 weeks. Phototherapy averaged 31.9 hours. Transcutaneous bilirubin and TSB showed strong agreement before PT, but accuracy decreased during treatment and 12 hours posttreatment, with TCB underestimating bilirubin levels. The correlation between methods remained high, with explained variance ranging from 41.2% to 84.9%. Accuracy did not vary by skin tone. Implications for Practice and Research: – The strong correlation between the 2 methods supports JM-105’s validity for tracking bilirubin trends over time. However, it may not accurately quantify serum bilirubin, reinforcing its use as a screening, rather than a diagnostic tool. The varying discrepancy between the 2 methods across time points suggests that accuracy may be influenced by measurement timing or treatment stage. Further research is needed to clarify these factors and their clinical relevance.