Comparative study of strip (stool color for triage of infants for phototherapy) score and transcutaneous bilirubinometer with serum bilirubin in predicting accuracy of neonatal hyperbilirubinemia.

Abstract

INTRODUCTION: Neonatal hyperbilirubinemia, marked by elevated bilirubin levels in newborns, can arise from various factors such as sepsis, ABO and Rh incompatibility, polycythemia, cephalhematoma, and dehydration. These conditions lead to hemolysis, liver dysfunction, or hindered bilirubin excretion. Preterm infants are particularly at risk due to immature liver function, and parity can influence outcomes through breastfeeding practices and hemolytic disease risks in subsequent pregnancies. Clinical assessment is essential for distinguishing physiological from pathological jaundice.

AIM & OBJECTIVES: This study aims to evaluate the effectiveness of the STrIP score and transcutaneous bilirubinometer against serum bilirubin levels in predicting neonatal hyperbilirubinemia. We seek to determine their accuracy and reliability and assess associated risk factors to enhance early detection and management of hyperbilirubinemia in newborns.

MATERIALS & METHODS: The study will include neonates over 35 weeks gestational age with clinical jaundice, obtaining parental consent. Serum bilirubin levels will be measured at 72 hours of life, and a clinical assessment will be conducted using the Kramer scale. The STrIP score will be calculated from stool samples and compared to transcutaneous bilirubin readings to assess accuracy using Bland-Altman analysis.

RESULTS: Among 290 newborns, 73.8% were term. Clinically significant jaundice was 2.03 times more common in primiparous mothers and significantly associated with gestational age, birth trauma, pregnancy complications, Rh status, and ABO incompatibility. Dehydration and polycythemia were strongly linked to neonatal hyperbilirubinemia, with males slightly more prevalent among participants.

CONCLUSION: The STrIP score provides enhanced predictive accuracy and a better correlation with serum bilirubin levels than the transcutaneous bilirubinometer. The study identifies significant associations between various factors and clinically significant jaundice, highlighting the importance of STrIP as a non-invasive option for managing neonatal jaundice.