Department of Neonatology, Service of Pediatrics, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Marítim 25-29, 08003, Barcelona, Spain.
AMIB (Assessoria Metodològica i Bioestadística) (Methodological and Biostatistical Consultancy), IMIM (Institut Hospital del Mar d'Investigacions Mèdiques) (Hospital del Mar Institute for Medical Research), Doctor Aiguader 88, 08003, Barcelona, Spain.
Eur J Pediatr. 2021 Feb;180(2):607-616. doi: 10.1007/s00431-020-03885-0. Epub 2021 Jan 6.
Measurement of transcutaneous bilirubin (TcB) is widely used to estimate serum bilirubin (SB). However, its reliability depending on skin tone is still controversial. Ethnic classification does not correlate well with skin tone. We aimed to determine the reliability of transcutaneous bilirubin in a multiethnic population based on skin color according to our neonatal skin color scale. We conducted a prospective, observational study comparing SB and TcB among different skin colors. With the blood sample routinely obtained at 48-72 h for the screening of inborn errors of metabolism, we determined SB and TcB with a jaundice meter. We obtained data from 1359 newborns (color 1 337, color 2 750, color 3 249, color 4 23) and analyzed 1549 dyads SB/TcB. Correlation between TcB and serum bilirubin was very good (R = 0.908-0.956), globally and by color group, with slight differences between darker and lighter skin colors. Bland-Altman plots showed different mean bias depending on skin color. Conclusions: Our study not only supports the reliability of TcB to assess SB regardless of skin color, but also supports the fact that TcB tends to overestimate SB in a higher degree in dark-skinned neonates. This may help reduce the number of blood samples for newborns. What is Known: • Jaundice meters are extensively used to diagnose neonatal hyperbilirubinemia, although controversies exist on their reliability depending on skin color. • Only a few studies have analyzed their accuracy in multiethnic populations, but none has used a validated neonatal skin color scale. What is New: • We verified correlation between serum and transcutaneous bilirubin in a multiethnic population depending on skin color after classifying our neonates into color groups with our own validated neonatal skin color scale.
经皮胆红素（TcB）的测量广泛用于估计血清胆红素（SB）。然而，其对肤色的可靠性仍存在争议。人种分类与肤色相关性不佳。我们旨在根据我们的新生儿肤色量表，根据肤色确定多民族人群中经皮胆红素的可靠性。我们进行了一项前瞻性、观察性研究，比较了不同肤色人群中 SB 和 TcB。通过对 48-72 小时的血液样本进行代谢缺陷的筛查，我们使用黄疸计测定 SB 和 TcB。我们从 1359 名新生儿（1 色 337 名，2 色 750 名，3 色 249 名，4 色 23 名）中获得数据，并分析了 1549 对 SB/TcB。TcB 与血清胆红素之间的相关性非常好（R = 0.908-0.956），全球和按肤色组，肤色较深和较浅的皮肤之间存在微小差异。Bland-Altman 图显示了根据肤色的不同平均偏差。结论：我们的研究不仅支持 TcB 评估 SB 无论肤色的可靠性，而且还支持 TcB 在深色皮肤新生儿中更倾向于高估 SB 的事实。这可能有助于减少新生儿的采血次数。已知的：•黄疸计广泛用于诊断新生儿高胆红素血症，尽管在其对肤色的可靠性方面存在争议。•只有少数研究分析了它们在多民族人群中的准确性，但没有一项研究使用了经过验证的新生儿肤色量表。新的：•我们使用我们自己验证的新生儿肤色量表将我们的新生儿分为颜色组后，在多民族人群中根据肤色验证了血清胆红素与经皮胆红素之间的相关性。
