Universal Transcutaneous Bilirubin Screening in a Midwifery-Led Home Care Setting

Does universal transcutaneous bilirubin (TCB) screening identify more neonates who require phototherapy compared with visual inspection, and is this strategy cost-effective?In this decision analytical model study of 2314 (near) full-term neonates cared for at home, universal TCB screening identified 21 additional cases of hyperbilirubinemia compared with visual inspection, saving €15 per neonate but requiring 102 extra heel pricks. Selective TCB screening for neonates with visual jaundice reduced additional heel pricks without compromising diagnostic accuracy.These findings support the use of TCB screening for neonates at home.

Corresponding Author: Lauren E. H. Westenberg, MD, Erasmus MC, Pediatrics, Doctor Molewaterplein 40, Rotterdam 3015 GD, the Netherlands (L.Westenberg@erasmusmc.nl).

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