Effect of universal neonatal transcutaneous bilirubin screening on blood draws for bilirubin analysis and phototherapy usage

J Perinatol. 2012 Nov;32(11):851-5. doi: 10.1038/jp.2012.10. Epub 2012 Feb 16.


Objective: To determine the effect of universal transcutaneous bilirubin (TcB) screening on total serum bilirubin (TSB) blood draws and phototherapy usage.

Study design: The subjects were infants ≥ 36 weeks gestation. In period 1, TSB was ordered based on clinical factors. In period 2, all infants underwent predischarge TcB measurement; infants with adjusted TcB values in the high-intermediate or high-risk zones had TSB ordered. Data were extracted through chart review.

Result: TSB measurements per 1000 infants decreased from 717 to 713 (P=0.008) between period 1 and 2, with more outpatient and less inpatient blood draws in period 2. Between periods 1 and 2, total phototherapy decreased from 59 to 39 per 1000 infants (P<0.0001), with less inpatient and more readmission phototherapy.

Conclusion: Universal TcB screening was implemented without increasing total blood draws or phototherapy treatment; however, it was associated with a shift in blood draws and phototherapy usage from inpatients to outpatients.

MeSH terms

  • Bilirubin / analysis*
  • Humans
  • Hyperbilirubinemia, Neonatal / epidemiology*
  • Hyperbilirubinemia, Neonatal / therapy*
  • Infant, Newborn
  • Laboratories, Hospital
  • Neonatal Screening* / trends
  • Phlebotomy / statistics & numerical data*
  • Phototherapy* / statistics & numerical data
  • Practice Guidelines as Topic
  • Retrospective Studies


  • Bilirubin