Transcutaneous versus Total Serum Bilirubin Measurements in Preterm Infants

<b><i>Introduction:</i></b> Transcutaneous bilirubin (TcB) measurement offers a noninvasive approach for screening; however, its accuracy in preterm infants is unclear. This study determined the agreement between TcB and total serum (TSB) among infants. <b><i>Methods:</i></b> A multisite prospective cohort was conducted at 3 NICUs Ontario, Canada, September 2016 to June 2018. Among 296 born 24<sup>0/7</sup> 35<sup>6/7</sup> weeks, 856 levels were taken forehead, sternum, before after initiation of phototherapy with TSB measurements. Bland-Altman plots 95% limits (LOA) expressed TSB. <b><i>Results:</i></b> The overall mean TcB-TSB difference −24.5 μmol/L (95% LOA −103.3 54.3), 1.6 −73.4 76.5) phototherapy, −31.1 −105.5 43.4) phototherapy. −15.2 −86.8 56.3) forehead −24.4 −112.9 64.0) sternum. −31.4 −95.3 32.4) 24–28 −25.5 −102.7 51.8) 29–32 −15.9 −107.4 75.6) 33–35 weeks. Measures did not differ by maternal ethnicity. <b><i>Conclusion:</i></b> infants, may offer noninvasive, immediate screening hyperbilirubinemia more careful use <33 weeks’ gestation, as approaches treatment thresholds. Its underestimation warrants clinical decision-making