Transcutaneous Bilirubin Screening as a Predictor of Readmission for Neonatal Jaundice

Background: Neonatal jaundice remains one of the most common reasons for hospital readmission within the first two weeks of life. Early identification of neonates at risk of significant hyperbilirubinemia prior to discharge could reduce preventable readmissions. Transcutaneous bilirubinometry (TcB) offers a noninvasive, rapid, and cost-effective screening modality, yet its predictive value for readmission has not been thoroughly characterized. Methods: This prospective cohort study enrolled 486 healthy term and late-preterm neonates born at a tertiary care hospital. Predischarge TcB measurements were obtained using the Dräger Jaundice Meter JM-105 within 6 hours prior to discharge. Neonates were followed for 14 days to ascertain readmission for phototherapyrequiring jaundice. Receiver operating characteristic (ROC) analysis was performed to evaluate the predictive accuracy of predischarge TcB values. Results: Of the 486 neonates, 52 (10.7%) were readmitted for jaundice requiring phototherapy. The mean predischarge TcB was significantly higher in readmitted neonates (12.8 ± 2.1 mg/dL) compared to nonreadmitted neonates (8.4 ± 2.6 mg/dL; p < 0.001). ROC analysis yielded an area under the curve (AUC) of 0.87 (95% CI: 0.83–0.91). A TcB cutoff of ≥10.5 mg/dL demonstrated a sensitivity of 84.6%, specificity of 78.3%, positive predictive value of 31.9%, and negative predictive value of 97.7%. Conclusion: Predischarge TcB measurement is a reliable noninvasive predictor of readmission for neonatal jaundice. Implementation of TcB-based screening protocols could facilitate targeted follow-up and reduce avoidable readmissions