WIP 22 - A Prospective Study on Correlation Between Transcutaneous Bilirubin and Serum Bilirubin in Preterm Neonates from 30-0/7 to 34-6/7 Weeks Gestation) Before, During, and After Phototherapy

Publication Number: WIP 22.7582

Sania Saood, The Children's Hospital at Monmouth Medical Center, Long Branch, NJ, United States; Meera Kale, Rutgers, Robert Wood Johnson Medical School, Long branch, NJ, United States

Background: Studies have supported a high correlation between transcutaneous bilirubin and serum bilirubin allowing early screening that is non-invasive and cheaper, without missing infants that may require phototherapy. However, currently available data supports the use of TcB screening only for infants 35 weeks gestation age or older. TcB allows for fewer blood draws in preterm neonates who may already need frequent blood draws, due to other comorbidities related to prematurity. Our study is being done to determine if there is a correlation between TcB readings and serum bilirubin levels in premature infants of 30-0/7 to 34-6/7 weeks gestational age in a diverse patient population based on gestational age, birth weight, postnatal age, race, gender, before/during/after phototherapy and anatomic sites in a Level III NICU. Long-term, the study results can help promote the use of non-invasive methods to monitor hyperbilirubinemia resulting in fewer painful procedures, and decreased overall cost.

Objective: - To determine the correlation between transcutaneous bilirubin and serum bilirubin in neonates born at 30-0/7 to 34-6/7 weeks gestational age
- To evaluate the differences in correlation based on the site of TcB extraction: forehead vs sternum
- To evaluate if correlation changes before, during, and after the participant undergoes phototherapy

Design/Methods: The study is being conducted over a span of 12 months, aiming to determine how transcutaneous bilirubin values approximate serum bilirubin measurements among preterm neonates of gestational ages between 30-0/7 to 34-6/7 weeks. After IRB approval, we started collecting data in February, 2024 and plan to continue until February, 2025, before completing data analysis in March, 2025. Relationship between TcB and TSB measurements will be investigated using linear regression analysis and Bland-Altman Plots. In this study where TSB is considered ‘gold standard’ which determines need for further management, it is the correct analysis tool because safety impact of replacing TSB with the TcB is being evaluated.