Bhutani-based nomograms for the prediction of significant hyperbilirubinaemia using transcutaneous measurements of bilirubin

  1. YA Bental1,2,
  2. Y Shiff1,
  3. N Dorsht3,
  4. E Litig1,
  5. L Tuval1,
  6. FB Mimouni4,5

Article first published online: 8 JUN 2009

DOI: 10.1111/j.1651-2227.2009.01385.x

Issue

Acta Paediatrica

Acta Paediatrica

Volume 98, Issue 12, pages 1902–1908, December 2009

Additional Information

How to Cite

Bental, Y., Shiff, Y., Dorsht, N., Litig, E., Tuval, L. and Mimouni, F. (2009), Bhutani-based nomograms for the prediction of significant hyperbilirubinaemia using transcutaneous measurements of bilirubin. Acta Paediatrica, 98: 1902–1908. doi: 10.1111/j.1651-2227.2009.01385.x

Author Information

  1. 1

    Neonatology, Laniado Hospital, Natanya, Israel

  2. 2

    The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

  3. 3

    Biochemical Laboratory, Laniado Hospital, Natanya, Israel

  4. 4

    Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel

  5. 5

    Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

*Y Bental, M.D., Department of Neonatology, Laniado Hospital, Divrei Chaim St., Natanya, Israel. Tel/Fax: 972-9-8609579 | Email: yabental@laniado.org.il

Publication History

  1. Issue published online: 2 NOV 2009
  2. Article first published online: 8 JUN 2009
  3. Received 8 February 2009; revised 21 April 2009; accepted 19 May 2009.

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Keywords:

  • Jaundice;
  • Newborn;
  • Nomograms;
  • Total serum bilirubin;
  • Transcutaneous bilirubin

Abstract

Aim:  Prospectively establish the relationship between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB), and develop nomograms similar to Bhutani’s nomograms, based on our TcB data.

Methods:  Our study sample was from a total population of 1069 infants, near term and term healthy newborns, admitted during 2.5 month period of the study. TSB was performed on all infants who were felt to be clinically jaundiced. Before obtaining the TSB, a TcB was performed (Jaundice Meter Minolta/Draeger JM-103). Measurements were performed on two sites: forehead and mid-sternum, and the mean of both measurements was calculated.

Results:  A total of 1091 paired measurements were obtained from 628 infants. Linear regression showed a significant relation between TSB and TcB (R2 of 0.846). In multiple regression analysis, all independent variables studied, i.e. gestational age (or birthweight), age at sampling and ethnicity had a negligible influence on the relationship. We subsequently developed our local-nomograms of hour-specific mean TcB with 40, 75 and 95 percentile lines.

Conclusions:  In our local settings and population, we found a reliable correlation between laboratory measurements of TSB and TcB. We were able to develop our local-Bhutani-based TcB nomograms for screening babies during hospital stay and pre-discharge for assessing the risk of hyperbilirubinaemia.

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