Although the gold standard remains the measurement of the serum bilirubin concentration, this method is not only invasive and painful to the newborn but also stressful to parents. Moreover, depending on the location of laboratory

services, there may be a delay before total serum bilirubin (TSB) results are available for management. Over the last two decades, transcutaneous bilirubinometry has been developed as a non-invasive, safe, painless, and convenient method for the estimation of total bilirubin level Inhibitors,research,lifescience,medical but has not been widely adopted due to concerns about its accuracy. In recent years, a newer generation of transcutaneous bilirubinometers has been Inhibitors,research,lifescience,medical marketed. One of these newer transcutaneous devices is the Bilicheck® (Respironics, USA), which measures skin bilirubin using reflectance of light from the whole visible spectrum (380-760 nm). It

differs from earlier models in that a multi-wavelength spectral reflectance technique allows the device to determine the optical densities attributed to bilirubin, dermal thickness, heme, and melanin in the epidermal and dermal layers in the infant skin.2 A large number of studies have reported on the significant correlation between the Bilicheck® transcutaneous bilirubin (TcB) readings and Inhibitors,research,lifescience,medical TSB in predominantly Caucasian,2,3 and Japanese neonates.4 Studies on Inhibitors,research,lifescience,medical primarily Hispanic,5 and Indian infants,6 who were more pigmented than Caucasians, showed that despite the significant correlation, TcB determinations underestimated TSB, especially in infants with relatively high TSB values. A Multiracial

Malay, Chinese, and Indian infants’ study,7 showed that the Bilicheck® is not an alternative to measuring serum bilirubin in infants with hyperbilirubinemia. Inhibitors,research,lifescience,medical The only study using this device in Iran was conducted in Tabriz (North West of Iran),8 which reported that TcB had a good sensitivity, while the specificity 47.5%. The aim of the present study was to determine the accuracy of the Bilicheck® for the measurement of total bilirubin level and to evaluate the effect of gestational age, postnatal age, or body weight on the Drug_discovery TcB level. In addition, we sought to identify the most reliable cut-off value with the highest sensitivity and specificity for bilirubin as measured by the Bilicheck® on the forehead. Subjects and Methods Subject This prospective study was carried out from October to November 2011. Totally, 560 healthy neonates with Hyperbilirubinemia, who were referred to the Neonatal Ward of Nemazee this Hospital affiliated to Shiraz University of Medical Sciences, were enrolled in this study.