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Transcutaneous bilirubin in newborns before, during, and after home phototherapy-Results from a secondary analysis of a randomized controlled trial
Department of Pediatrics, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0009-0002-2995-0280
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Pediatrics.ORCID iD: 0000-0003-3762-7627
Örebro University, School of Health Sciences. Department of Pediatrics, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-5996-2584
Department of Pediatrics, Faculty of Medicine and Health, Falu Hospital, Örebro, Sweden.
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2025 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 20, no 3, article id e0320067Article in journal (Refereed) Published
Abstract [en]

Home phototherapy is recommended as an alternative to hospital-based therapy for neonatal jaundice in otherwise healthy full-term infants. With a reliable device for transcutaneous bilirubin (TcB) measurement, bilirubin values could be monitored at home during treatment. This study aimed to examine the accuracy of TcB measurement of bilirubin levels before, during, and after home phototherapy. Patients requiring phototherapy were assigned to home (intervention) or hospital-based phototherapy (control). Transcutaneous bilirubin measurement was made at the sternum (uncovered skin) and at sacrum (covered by the diaper during treatment). Simultaneously, total serum bilirubin (TSB) level was collected through a blood sample. The agreement between TcB and TSB before, during, and after phototherapy was assessed using Bland-Altman plots. Altogether 141 patients and 856 paired bilirubin values were included. The results show that TcB measurements underestimate TSB levels. Before phototherapy, the mean difference between TcB and TSB was 75 ± 36 μmol/L at the sternum and 135 ± 39 μmol/L at sacrum, with no difference between study groups. During phototherapy, the mean difference at the sternum was larger in the control group, 105 ± 73 μmol/L, than in the intervention group, 50 ± 41 μmol/L; at sacrum, the mean difference was 125 ± 44 μmol/L, comparable in both study groups. After phototherapy, the TcB-TSB agreement improved, with a mean difference of 29 ± 33 μmol/L (sternum) and 87 ± 35 μmol/L (sacrum), and no difference between study groups. In conclusion this study shows that full-term infants who qualified for phototherapy show poor agreement between TcB measurement and TSB, suggesting that TcB measurements cannot replace measurement of TSB level before, during, or after home phototherapy.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2025. Vol. 20, no 3, article id e0320067
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Pediatrics
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URN: urn:nbn:se:oru:diva-120200DOI: 10.1371/journal.pone.0320067ISI: 001456921600025PubMedID: 40131901Scopus ID: 2-s2.0-105001360145OAI: oai:DiVA.org:oru-120200DiVA, id: diva2:1947486
Available from: 2025-03-26 Created: 2025-03-26 Last updated: 2026-01-23Bibliographically approved

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Pettersson, MiriamEriksson, MatsOhlin, Andreas

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Erlandsson Speychal, FeliciaPettersson, MiriamEriksson, MatsOhlin, Andreas
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