Use of transcutaneous bilirubinometers in preterm infants in Japan

BACKGROUND: This study aimed to investigate the current use of transcutaneous bilirubinometers (TcBMs) in preterm infants in Japan, given their potential for noninvasive and prolonged jaundice monitoring. METHODS: A nationwide questionnaire survey was conducted across 229 facilities for preterm infants. Responses were stratified by facility level and analyzed using Fisher's exact test. RESULTS: Of the 229 facilities, 149 (65%) responded, with 76 (51%) using TcBMs in preterm infants. TcBM use increased with gestational age. TcBMs were more commonly used in Level II facilities than in Level III/IV facilities (63% vs. 40%, p = 0.0087). In late preterm infants, TcBMs tended to be used immediately after birth, whereas in extremely preterm infants, they were often introduced after the first postnatal week. Level II facilities showed a tendency to use TcBMs immediately after birth, even in infants of relatively low gestational age. JM-105 was the most used device, and the anterior chest was the primary measurement site. 55% of the facilities using TcBMs reported adopting Morioka's new treatment criteria for neonatal jaundice. While most facilities disinfected devices after each use, concerns remained regarding measurement accuracy and infection control. CONCLUSION: TcBMs are used in approximately half of the facilities in Japan, with greater use in Level II centers. Broader dissemination of guidelines may encourage safer and more consistent practices.