Transcutaneous bilirubinometry for the screening of neonatal hyperbilirubinemia ≥35 weeks' gestation

Institute of Health Economics
Record ID 32013000856
Authors' recomendations: Early hospital discharge policies have resulted in increased hospital readmission rates of healthy term or late preterm neonates for phototherapy and in a resurgence of kernicterus—a serious neurological damage. Timely identification of neonates at high risk for severe neonatal hyperbilirubinemia is encouraged as a preventive strategy. TcB, a rapid, non-invasive, point-of-care test for predicting neonatal hyperbilirubinemia, has undergone clinical investigation in different countries and clinical settings for its reliability and accuracy. Performance of TcB in predicting hyperbilirubinemia, as measured by BiliCheck or JM-103 devices, has been examined in term or late-preterm neonates from various ethnic origins. Research findings suggested that TcB is a safe procedure. TcB cannot replace TSB but can be considered a valid screening tool to determine the need for a confirmatory TSB test. A TcB cut-off of ≥75th percentile at 48 to 72 hours of age (pre-discharge) is a good predictor of TSB of ≥95th percentile. TcB appears to be a promising technology and may be a useful addition to clinical assessment in the screening of neonatal jaundice. Evidence from five studies (one conducted in Canada) suggested that the implementation of a TcB screening program was associated with a reduction in the number of TSB tests but without an increase in the incidence of significant neonatal hyperbilirubinemia. Several aspects should be taken into consideration when planning to implement a universal TcB screening program, including the availability and cost of TcB devices, the need to develop a local TcB nomogram, the selection of appropriate TcB cutoff values (a balance between 100% sensitivity with low specificity and maximal screening accuracy), the appropriate quality assurance, training, and education of personnel, and the impact on the demand for community resources.
Project Status: Completed
Year Published: 2013
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Humans
  • Infant, Newborn
  • Hyperbilirubinemia, Neonatal
  • Diagnostic Techniques, Obstetrical and Gynecological
Organisation Name: Institute of Health Economics
Contact Address: 1200, 10405 – Jasper Avenue, Edmonton, AB T5J 3N4, Canada. Tel: +1 780 448 4881 Fax: +1 780 448 0018
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Copyright: Institute of Health Economics (IHE)
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