Plaza Laia, Saladrigues Neus Roca, Torrabías Meritxell, Bueno Fina, Damas Marina, Parès Carmina, Altimiras Jacint, Rodríguez González Marta
Faculty of Medicine, Universitat de Vic-Universitat Central de Catalunya, 08500 Vic, Spain.
Pediatric Department, Consorci Hospitalari de Vic, 08500 Vic, Spain.
Children (Basel). 2025 May 16;12(5):643. doi: 10.3390/children12050643.
Pathological hyperbilirubinemia often leads to hospital readmission within the first week of life, with increased risk of neurological damage if untreated. Transcutaneous bilirubin (TcB) measurement was integrated into neonatal screening to estimate total serum bilirubin (SB) concentrations. Despite TcB and SB generally correlating well, discrepancies can occur based on race/ethnicity. Falsely elevated TcB readings may be obtained in darker skin pigmentation.
This study compared TcB and SB across different ethnic groups to assess correlation patterns and identify the best TcB measurement method in neonates.
Term and late preterm neonates delivered at the University Hospital of Vic were included. Each newborn underwent TcB assessment (in the forehead, sternum, and both sites simultaneously) concomitantly with SB measurement. The correlations between both parameters were analyzed.
A total of 148 neonates were categorized as White/Caucasian (58), Chinese (3), Indian (17), Black/African (22), Latino (11), Arab (25), or mixed (12). The groups were homogeneous, with statistical differences in delivery and feeding ( = 0.032 and < 0.001). Differences between TcB and SB were -0.19 for White/Caucasian, 0.90 for Chinese, 1.12 for Indian, 2.47 for Black/African, 0.42 for Latino, and -0.08 for Arab ( < 0.001). A high association between TcB and SB was obtained with all measurement methods: r = 0.836 in forehead, r = 0.869 in midsternum, and r = 0.863 when both locations were combined ( < 0.001).
TcB correlated well with SB, but accuracy varied among ethnic groups. An individualized interpretation of TcB based on skin pigmentation is supported. Mid-sternum determination was the best TcB measurement method.
病理性高胆红素血症常导致新生儿在出生后第一周内再次入院，若不治疗，神经损伤风险增加。经皮胆红素（TcB）测量已纳入新生儿筛查，以估计血清总胆红素（SB）浓度。尽管TcB与SB通常相关性良好，但基于种族/民族可能会出现差异。皮肤色素沉着较深时可能会出现TcB读数假性升高。
本研究比较不同种族群体的TcB和SB，以评估相关模式并确定新生儿最佳的TcB测量方法。
纳入在维克大学医院分娩的足月儿和晚期早产儿。每个新生儿在测量SB的同时进行TcB评估（在前额、胸骨以及两个部位同时进行）。分析两个参数之间的相关性。
总共148例新生儿被分类为白人/高加索人（58例）、中国人（3例）、印度人（17例）、黑人/非洲人（22例）、拉丁裔（11例）、阿拉伯人（25例）或混血儿（12例）。这些群体具有同质性，在分娩和喂养方面存在统计学差异（P = 0.032和P < 0.001）。白人/高加索人的TcB与SB差值为-0.19，中国人为0.90，印度人为1.12，黑人/非洲人为2.47，拉丁裔为0.42，阿拉伯人为-0.08（P < 0.001）。所有测量方法均显示TcB与SB之间具有高度相关性：前额测量时r = 0.836，胸骨测量时r = 0.869，两个部位联合测量时r = 0.863（P < 0.001）。
TcB与SB相关性良好，但不同种族群体的准确性有所不同。支持基于皮肤色素沉着对TcB进行个体化解读。胸骨中部测量是最佳的TcB测量方法。
