ความแม่นยำของการวัดระดับบิลิรูบินผ่านทางผิวหนังเปรียบเทียบกับการวัดระดับ ไมโครบิลิรูบินในซีรัมของทารกแรกเกิด: The Accuracy of Transcutaneous Bilirubin Measurements Compare with Serum Microbilirubin of Neonate

บทคัดย่อ

The serum microbilirubin level was used for screening of neonatal hyperbilirubinemia. This diagnostic study aimed to evaluate the accuracy of transcutaneous bilirubin measurements at forehead and sternum compared with serum microbilirubin. Populations were newborn, in Phichit hospital, at gestational age (GA) ≥ 35 weeks and birth weight ≥ 2,500 grams or GA ≥ 36 weeks and birth weight ≥ 2,000 grams. Serum microbilirubin and transcutaneous bilirubin level were collected at forty eight hours after birth by Bilirubin Tester and Jaundice Meter JM-105 respectively, from 1st April 2015- 30th September 2015. Of the total newborns 295 cases, 168 cases (56.9%) were male. Mean ± SD of gestational age, weight and length of stay was 38.37 ± 2.84 weeks, 3,112.48 ± 425.97 grams and 3.15 ± 1.02 days respectively. Cut off point of bilirubin at ≥ 13 mg/dl showed Area Under the Curve (AUC) of transcutaneous bilirubin at sternum compared to serum microbilirubin was 0.806 (95%CI 0.72-0.89, p-value < 0.005) and higher than Area Under the Curve of transcutaneous bilirubin at forehead. The sensitivity, specificity, positive predictive value,
negative predictive value, positive likelihood ratio and negative likelihood ratio of transcutaneous bilirubin at sternum were 59.26%, 88.34%, 45.71%, 92.90%, 5.08 and 0.46 respectively. In conclusion, transcutaneous bilirubin at sternum demonstrated significant and higher correlation than transcutaneous bilirubin at forehead when compared with serum microbilirubin. This result should be applied to the context of each hospitals to ensure maximum benefit to the patients.