Defining the limitations of transcutaneous bilirubin measurement in late preterm newborns

Objective:the objective of this study is to determine the impact of postnatal age on the bias between transcutaneous (tcb) and total serum bilirubin (tsb), and evaluate a tcb screening protocol.study design:preterm and term infants had paired tcb and tsb performed on days 1 to 3 of life; a subset of preterm infants had measurements on days 4 to 7. sensitivity and specificity of tcb (plotted on an age-specific tsb nomogram) for prediction of high-intermediate (hir) or high-risk tsb were calculated.results:median tcb bias was 2.6 and 2.5 mg dl−1 for term and preterm infants in the first 3 days of life, respectively. however, median bias was 2.2 mg dl−1 for preterm infants at 4 to 7 days of life. tcb in preterm infants predicted hir or high-risk tsb with 94% sensitivity and 56% specificity.conclusion:tcb screening protocols developed for term infants can be used for late preterm infants in the first 3 days of life.