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Abstract

Introduction: Neonatal hyperbilirubinemia is a common and potentially serious condition affecting a large proportion of term and preterm neonates. While total serum bilirubin (TSB) remains the gold standard for diagnosis, transcutaneous bilirubinometry (TcB) offers a non-invasive, rapid alternative.
Objective: To compare the diagnostic accuracy of transcutaneous bilirubin measurements with serum bilirubin levels in late preterm and full-term neonates, and to evaluate the performance of two TcB anatomical sites—forehead and sternum—using age-specific bilirubin thresholds.
Methods: A prospective observational study was conducted on 100 neonates (35–42 weeks gestation) at a tertiary care center in rural Southern Rajasthan. TcB readings from the forehead and sternum were compared with TSB values. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and regression analysis were used for performance evaluation.
Results: Forehead TcB showed a sensitivity of 85.0%, specificity of 95.0%, and AUC of 0.92. Sternum TcB had a sensitivity of 83.8%, specificity of 90.0%, and AUC of 0.89. Bland-Altman analysis showed mild underestimation of TSB by TcB at both sites, with acceptable agreement. Regression analysis indicated strong linear correlation with R² values of 0.77 (forehead) and 0.81 (sternum).
Conclusion: TcB is a reliable screening tool for neonatal jaundice in rural healthcare settings. Though it cannot replace TSB entirely, it can significantly reduce the need for invasive testing and enhance early detection