Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups

Background: 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) concentrati...

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Main Authors: Laia Plaza, Neus Roca Saladrigues, Meritxell Torrabías, Fina Bueno, Marina Damas, Carmina Parès, Jacint Altimiras, Marta Rodríguez González
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/5/643
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author Laia Plaza
Neus Roca Saladrigues
Meritxell Torrabías
Fina Bueno
Marina Damas
Carmina Parès
Jacint Altimiras
Marta Rodríguez González
author_facet Laia Plaza
Neus Roca Saladrigues
Meritxell Torrabías
Fina Bueno
Marina Damas
Carmina Parès
Jacint Altimiras
Marta Rodríguez González
author_sort Laia Plaza
collection DOAJ
description Background: 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. Aims: This study compared TcB and SB across different ethnic groups to assess correlation patterns and identify the best TcB measurement method in neonates. Methods: 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. Results: 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 (<i>p</i> = 0.032 and <i>p</i> < 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 (<i>p</i> < 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 (<i>p</i> < 0.001). Conclusions: 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.
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spelling doaj-art-89064470545a4870be06144ece6d74082025-08-20T01:56:20ZengMDPI AGChildren2227-90672025-05-0112564310.3390/children12050643Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic GroupsLaia Plaza0Neus Roca Saladrigues1Meritxell Torrabías2Fina Bueno3Marina Damas4Carmina Parès5Jacint Altimiras6Marta Rodríguez González7Faculty of Medicine, Universitat de Vic-Universitat Central de Catalunya, 08500 Vic, SpainPediatric Department, Consorci Hospitalari de Vic, 08500 Vic, SpainPediatric Department, Consorci Hospitalari de Vic, 08500 Vic, SpainPediatric Department, Consorci Hospitalari de Vic, 08500 Vic, SpainPediatric Department, Consorci Hospitalari de Vic, 08500 Vic, SpainPediatric Department, Consorci Hospitalari de Vic, 08500 Vic, SpainClinical Epidemiology Department, Hospital Universitari de Vic, 08500 Vic, SpainPediatric Department, Consorci Hospitalari de Vic, 08500 Vic, SpainBackground: 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. Aims: This study compared TcB and SB across different ethnic groups to assess correlation patterns and identify the best TcB measurement method in neonates. Methods: 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. Results: 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 (<i>p</i> = 0.032 and <i>p</i> < 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 (<i>p</i> < 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 (<i>p</i> < 0.001). Conclusions: 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.https://www.mdpi.com/2227-9067/12/5/643neonatal hyperbilirubinemianeonatal jaundicekernicterusphototherapyethnicityskin pigmentation
spellingShingle Laia Plaza
Neus Roca Saladrigues
Meritxell Torrabías
Fina Bueno
Marina Damas
Carmina Parès
Jacint Altimiras
Marta Rodríguez González
Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups
Children
neonatal hyperbilirubinemia
neonatal jaundice
kernicterus
phototherapy
ethnicity
skin pigmentation
title Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups
title_full Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups
title_fullStr Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups
title_full_unstemmed Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups
title_short Study of the Variability of Transcutaneous Bilirubin Determinations Between Different Ethnic Groups
title_sort study of the variability of transcutaneous bilirubin determinations between different ethnic groups
topic neonatal hyperbilirubinemia
neonatal jaundice
kernicterus
phototherapy
ethnicity
skin pigmentation
url https://www.mdpi.com/2227-9067/12/5/643
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