Concurrent measurement of total transcutaneous bilirubin over forehead and sternum as predictive model for total serum bilirubin in prem ature and term newborns

Abstract

Background. Detection of hyperbilirubinemia in newborn has become a challenge for health care systems. The aim of the study was to prove the usefulness of concurrent total transcutaneous bilirubin measurement over forehead (TTBf) and total transcutaneous bilirubin over sternum (TTBs) as predictive model for total serum bilirubin (TSB) in premature and term newborns. Material and Method. Transversal and analytical study in 30-42 gestation week newborns from January 21st to April 30th 2013 in a gynecology, obstetrics and neonatology specialties public hospital. Pearson´s correlation for TSB/TTBf and TSB/TTBs was carried out. Linear regression analysis for one and several predictive variables were performed. Results. For 89 concurrent measurements, the correlation TSB/TTBf was 0.8411 and for TSB/TTBs, 0.7942 (p value < 2.2E-16 in both cases). With simple regression analysis for TSB and TTBf, the equation was: TSB = 2.1187 + 0.7035 × TTBf (p < 2.2E-16, R2 = 70.75%, R2 adjusted = 70.41%); for TSB and TTBs the equation was: TSB = 2.0405 + 0.6349 × TTBs (p < 2.2E-16, R2 = 63.07%, R2 adjusted = 62.65%). With multiple regression analysis for TSB vs. TTBf, TTBs, the equation was: BTS = 1.620 + 0.503 × TTBf + 0.224 × TTBs (p < 2.2 E-16, R2 = 72.87%, R2 adjusted = 72.24%). Conclusions. It was demonstrated that TTBf, TTBs model allowed to obtain better TSB prediction than TTB single measurement models for in-patient premature and term newborns. Key words: Transcutaneous bilirubin, bilirubinometer, neonatal hyperbilirubinemia, kernicterus.

Keywords

• bilirrubina transcutánea
• bilirrubinómetro
• hiperbilirubinemia neonatal
• kernícterus