{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:42:55Z","timestamp":1791340975264,"version":"4.3.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004156","name":"Mahidol University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004156","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of the study was to investigate correlation and concordance between total serum bilirubin (TSB) and transcutaneous bilirubin measured at covered (TcBC) and uncovered (TcBU) skin during and after discontinuation of phototherapy. A cross-sectional study included\u2009\u2265\u200934\u00a0weeks gestation infants requiring phototherapy for neonatal hyperbilirubinemia. In-house, photo-opaque patches were placed on infants\u2019 sternums before phototherapy initiation. Simultaneous blood sampling for TSB, TcBC, and TcBU measurements were performed. Among 103 infants\u00a0included in the\u00a0final analysis, 70% were full-term. Covering skin during phototherapy resulted in strong TcBC-TSB correlation (<jats:italic>r<\/jats:italic>\u2009=\u20090.91, 95% CI 0.87\u20130.94, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) compared to TcBU (<jats:italic>r<\/jats:italic>\u2009=\u20090.53, 95% CI 0.37\u20130.65, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), persisting post-phototherapy (<jats:italic>r<\/jats:italic>\u2009=\u20090.88, 95% CI 0.82\u20130.91, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Bland\u2013Altman analysis showed a higher mean difference and wider 95% limits of agreement for TcBU-TSB during phototherapy (-6.3\u00a0mg\/dL and -11.1 to -1.6) vs TcBC-TSB (0.9\u00a0mg\/dL and -1.2 to 2.9). Passing-Bablok regression analysis confirmed good agreement between TcBC and TSB.<\/jats:p><jats:p><jats:italic>Conclusions<\/jats:italic>: The application of in-house, photo-opaque patches enhanced the correlation and agreement between TcBC and TSB during and after discontinuation of phototherapy. This may prove particularly useful in resource-limited settings where commercial devices are unavailable. \n<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td align=\"left\"><jats:bold>What is Known<\/jats:bold>:<\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\">\u2022 <jats:italic>Transcutaneous bilirubin measurement has been widely used as a screening method for neonatal hyperbilirubinemia.<\/jats:italic>\u2022 <jats:italic>The accuracy of transcutaneous bilirubin measurements during and after phototherapy in infants with hyperbilirubinemia has been debated.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\"><jats:bold>What is New<\/jats:bold>:<\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\">\u2022 <jats:italic>Our study demonstrated that utilizing carefully designed photo-opaque patches enhanced the accuracy of transcutaneous bilirubin measurement during and after phototherapy.<\/jats:italic>\u2022 <jats:italic>Effective in-house alternatives are crucial in resource-limited settings where commercial opaque patches are not always accessible or affordable.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-024-05724-y","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T19:02:10Z","timestamp":1726254130000},"page":"5037-5041","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Validity of transcutaneous bilirubin measurements during and after phototherapy in term and late preterm infants"],"prefix":"10.1007","volume":"183","author":[{"given":"Nirucha","family":"Thamwiriyakul","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pitiporn","family":"Siripattanapipong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaiporn","family":"Bowornkitiwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renoo","family":"Chaweerat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9400-2936","authenticated-orcid":false,"given":"Sopapan","family":"Ngerncham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"5724_CR1","doi-asserted-by":"publisher","first-page":"e2022058859","DOI":"10.1542\/peds.2022-058859","volume":"150","author":"AR Kemper","year":"2022","unstructured":"Kemper AR, Newman TB, Slaughter JL, Maisels MJ, Watchko JF, Downs SM et al (2022) Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics 150:e2022058859","journal-title":"Pediatrics"},{"key":"5724_CR2","first-page":"CD012660","volume":"5","author":"CI Okwundu","year":"2023","unstructured":"Okwundu CI, Olowoyeye A, Uthman OA, Smith J, Wiysonge CS, Bhutani VK et al (2023) Transcutaneous bilirubinometry versus total serum bilirubin measurement for newborns. Cochrane Database Syst Rev 5:CD012660","journal-title":"Cochrane Database Syst Rev"},{"key":"5724_CR3","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1159\/000442195","volume":"109","author":"G Nagar","year":"2016","unstructured":"Nagar G, Vandermeer B, Campbell S, Kumar M (2016) Effect of Phototherapy on the Reliability of Transcutaneous Bilirubin Devices in Term and Near-Term Infants: A Systematic Review and Meta-Analysis. Neonatology 109:203\u2013212","journal-title":"Neonatology"},{"key":"5724_CR4","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1038\/jp.2016.189","volume":"37","author":"L Murli","year":"2017","unstructured":"Murli L, Thukral A, Sankar MJ, Vishnubhatla S, Deorari AK, Paul VK et al (2017) Reliability of transcutaneous bilirubinometry from shielded skin in neonates receiving phototherapy: a prospective cohort study. J Perinatol 37:182\u2013187","journal-title":"J Perinatol"},{"key":"5724_CR5","first-page":"323","volume":"19","author":"M Radfar","year":"2016","unstructured":"Radfar M, Hashemieh M, Shirvani F, Madani R (2016) Transcutaneous Bilirubinometry in Preterm and Term Newborn Infants before and during Phototherapy. Arch Iran Med 19:323\u2013328","journal-title":"Arch Iran Med"},{"key":"5724_CR6","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1542\/peds.114.1.297","volume":"114","author":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia","year":"2004","unstructured":"American Academy of Pediatrics Subcommittee on Hyperbilirubinemia (2004) Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 114:297\u2013316","journal-title":"Pediatrics"},{"key":"5724_CR7","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1038\/jp.2012.71","volume":"32","author":"MJ Maisels","year":"2012","unstructured":"Maisels MJ, Watchko JF, Bhutani VK, Stevenson DK (2012) An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation. J Perinatol 32:660\u2013664","journal-title":"J Perinatol"},{"key":"5724_CR8","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/j.1651-2227.2003.tb00554.x","volume":"92","author":"KL Tan","year":"2003","unstructured":"Tan KL, Dong F (2003) Transcutaneous bilirubinometry during and after phototherapy. Acta Paediatr 92:327\u2013331","journal-title":"Acta Paediatr"},{"key":"5724_CR9","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.earlhumdev.2009.05.010","volume":"85","author":"E Zecca","year":"2009","unstructured":"Zecca E, Barone G, De Luca D, Marra R, Tiberi E, Romagnoli C (2009) Skin bilirubin measurement during phototherapy in preterm and term newborn infants. Early Hum Dev 85:537\u2013540","journal-title":"Early Hum Dev"},{"key":"5724_CR10","doi-asserted-by":"publisher","first-page":"E17","DOI":"10.1542\/peds.106.2.e17","volume":"106","author":"VK Bhutani","year":"2000","unstructured":"Bhutani VK, Gourley GR, Adler S, Kreamer B, Dalin C, Johnson LH (2000) Noninvasive measurement of total serum bilirubin in a multiracial predischarge newborn population to assess the risk of severe hyperbilirubinemia. Pediatrics 106:E17","journal-title":"Pediatrics"},{"key":"5724_CR11","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1542\/peds.113.6.1628","volume":"113","author":"MJ Maisels","year":"2004","unstructured":"Maisels MJ, Ostrea EM Jr, Touch S, Clune SE, Cepeda E, Kring E et al (2004) Evaluation of a new transcutaneous bilirubinometer. Pediatrics 113:1628\u20131635","journal-title":"Pediatrics"},{"key":"5724_CR12","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1001\/archpediatrics.2009.187","volume":"163","author":"D De Luca","year":"2009","unstructured":"De Luca D, Jackson GL, Tridente A, Carnielli VP, Engle WD (2009) Transcutaneous bilirubin nomograms: a systematic review of population differences and analysis of bilirubin kinetics. Arch Pediatr Adolesc Med 163:1054\u20131059","journal-title":"Arch Pediatr Adolesc Med"},{"key":"5724_CR13","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.jpeds.2017.05.080","volume":"188","author":"D De Luca","year":"2017","unstructured":"De Luca D, Dell\u2019Orto V (2017) Patched Skin Bilirubin Assay to Monitor Neonates Born Extremely Preterm Undergoing Phototherapy. J Pediatr 188:122\u2013127","journal-title":"J Pediatr"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-024-05724-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-024-05724-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-024-05724-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T07:06:05Z","timestamp":1728889565000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-024-05724-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,13]]},"references-count":13,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["5724"],"URL":"https:\/\/doi.org\/10.1007\/s00431-024-05724-y","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,13]]},"assertion":[{"value":"16 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 September 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Siriraj Institutional Review Board, Faculty of Medicine Siriraj Hospital, Mahidol University (COA Si 756\/2016). Written informed consent was obtained from the mothers of all neonates. The study was retrospectively registered in the Thai Clinical Trials Registry (TCTR20200917004) on September 17, 2020, one of the primary registries of the WHO Registry Network.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}