Impact of Skin Tone on the Performance of a Transcutaneous Jaundice Meter

Acta Paediatr. 2009 Dec;98(12):1909-15. doi: 10.1111/j.1651-2227.2009.01497.x. Epub 2009 Sep 17.


Aim: To evaluate the performance of the Konica Minolta/Air-Shields JM-103 jaundice meter on the basis of infant skin tone during the early neonatal period.

Methods: Infants were prospectively categorized into light, medium and dark skin tone groups relative to two reference colours. Transcutaneous bilirubin readings were taken at predetermined intervals through the early neonatal period on a convenience sample of 938 healthy infants > or =37 weeks gestation. Serum bilirubin measurements were drawn routinely with metabolic studies and repeated in the presence of an elevated transcutaneous reading or clinically significant jaundice.

Results: Multivariate linear regression analysis showed a significant impact on serum and transcutaneous bilirubin agreement by skin tone. Highest precision and lowest bias were observed for medium skin toned infants. Greater disagreement between serum and transcutaneous measurements was noted at serum bilirubin concentrations >200 micromol/L. Insufficient numbers of dark skin toned infants were enrolled to evaluate fully the performance of the jaundice meter for this group.

Conclusion: The JM-103 jaundice meter displayed good correlation with serum bilirubin concentrations in light and medium skin tone infants, although it showed a tendency to under-read in the lighter skin tone group and to over-read in the darker skin tone group. The device shows excellent performance characteristics for use as a screening device.

Publication types

  • Evaluation Study

MeSH terms

  • Bilirubin / blood*
  • Female
  • Humans
  • Infant, Newborn
  • Jaundice, Neonatal / diagnosis*
  • Jaundice, Neonatal / ethnology
  • Linear Models
  • Male
  • Multivariate Analysis
  • Neonatal Screening / instrumentation*
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Skin Pigmentation*


  • Bilirubin