Transcutaneous bilirubinometry. Evaluation of accuracy and reliability in a large population.

A total of 576 transcutaneous bilirubin measurements were performed on 336 Japanese full-term breast-fed newborn infants during the first twelve days of life. Our present study revealed that transcutaneous bilirubin measurements obtained from the forehead, chest, and sternum correlated well with serum bilirubin concentrations measured by AO bilirubinometer (0.910-0.922, p less than 0.001, n = 576). The 95% confidence limits were +/- 3.04 mg/dl for the forehead, +/- 2.85 mg/dl for the chest, and +/- 2.84 mg/dl for the sternum readings. The overall mean of values from the forehead, chest and sternum, when compared with individual means, was found to correlate better with serum bilirubin concentrations (r = 0.930, p less than 0.001, n = 576) and improve the 95% confidence limits to +/- 2.68 mg/dl. These results demonstrated that the accuracy and reliability of TcB measurement could be increased further with multiple site measurement. The study clearly indicates that transcutaneous bilirubinometry is useful for clinical screening of serum bilirubin levels in Japanese full-term newborn infants.