Accuracy of transcutaneous bilirubin determination in neonatal hyperbilirubinemia: a meta-analysis

Michael  M. Resurreccion,; Jean Kamil  L. Sy,

Accuracy of transcutaneous bilirubin determination in neonatal hyperbilirubinemia: a meta-analysis

Jean Kamil L. Sy | Michael M. Resurreccion

Abstract:

BACKGROUND: Timely initiation of therapy for neonatal hyperbilirubinemia is routinely made based on total serum bilirubin levels. However, serial samplings by invasive needle pricks are needed for laboratory analyses. Studies comparing the correlation between serum bilirubin and transcutaneous bilirubin have yielded diverse results. A meta- analysis was done to find out the relationship between transcutaneous bilirubin measurements and serum bilirubin values. OBJECTIVE: This study aims to analyze scientific articles regarding the accuracy of transcutaneous bilirubin measurements among healthy neonates as an alternative screening for hyperbilirubinemia. STUDY DESIGN: Diagnostic Accuracy meta- analysis METHODS: Studies on the accuracy of transcutaneous bilirubin measurements were identified through intensive literature search. Local studies were confirmed thru personal communication. RESULTS: Three hundred eighteen studies were identified through literature search. Ten studies met the eligibility criteria. Eight of the ten studies reported results as correlation coefficients. The pooled estimates of correlation coefficients is high at r = 0.85 (95% CI = 0.84 to 0.857). Five studies reported results with data for diagnostic accuracy. The pooled analysis for sensitivity and specificity are high at 0.84 (95% CI 0.8-0.88) and 0.79 (95% CI 0.77-0.81) respectively. The pooled likelihood ratio has a significant difference with a pooled positive LR of 4.19 (95% CI 2.98-5.9, P<0.01) while the negative likelihood ratio is 0.23 (95% CI: 0.17 to 0.29). The AUC for transcutaneous bilirubinometry is 0.89. CONCLUSIONS: Transcutaneous bilirubin measurement can be an alternative in monitoring the risk of healthy neonates for hyperbilirubinemia based on the pooled analysis of correlation coefficient and diagnostic accuracy.

References:

Alsaedi S. Transcutaneous bilirubin measurement in healthy Saudi term newborns. Saudi Med J. 2016 Feb;37(2):142-6.
Bhutani VK, Gourley GR, Adler S, Kreamer B, Dalin C, Johnson LH. Noninvasive measurement of total serum bilirubin in a multiracial predischarge newborn population to assess the risk of severe hyperbilirubinemia. Pediatrics. 2000;106(2).
Olusanya BO, Imosemi DO, Emokpae AA. Differences between transcutaneous and serum bilirubin measurements in Black African neonates. Pediatrics. 2016;138(3).
Boo NY, Ishak S. Prediction of severe hyperbilirubinaemia using the BiliCheck transcutaneous bilirubinometer. J Paediatr Child Health. 2007;43:297-302.
Holland L. Implementing and validating transcutaneous bilinometry for neonates. Am J Clin Pathol. 2009 Oct;132(4):555-61.
Kolman KB, Mathieson KM, Frias C. A comparison of transcutaneous and total serum bilirubin in newborn Hispanic infants at 35 or more weeks of gestation. J Am Board Fam Med. 2007;20:266-71.
Mohamed I, Blanchard AC, Delvin E, Cousineau J, Carceller A. Plotting transcutaneous bilirubin measurements on specific transcutaneous nomogram results in better prediction of significant hyperbilirubinemia in healthy term and near-term newborns: a pilot study. Neonatology. 2014;105:306-11.
Romagnoli C, Catenazzi P, Barone G, Giordano L, Riccardi R, Zuppa AA, et al. BiliCheck vs JM-103 in identifying neonates not at risk of hyperbilirubinaemia. Ital J Pediatr. 2013;39:46.
Srinivas GL, Cuff CD, Ebeling MD, McElligott JT. Transcutaneous bilirubinometry is a reliably conservative method of assessing neonatal jaundice. J Matern Fetal Neonatal Med. 2015:1-5.
Zhan C, et al. Evaluation of the BiliCheck transcutaneous bilirubinometer in Chinese newborns. Biomed Res. 2016;27(4):1390-4.
Muchowski K, et al. Evaluation and treatment of neonatal hyperbilirubinemia. Am Fam Physician. 2014 Jun 1;98(11):873-8.
Nagar G. Reliability of transcutaneous bilirubin devices in preterm infants: a systematic review. Pediatrics. 2013;132:871-81.