CONTEXT Transcutaneous bilirubinometry (TcB) is used as a valid screening to identify neonates requiring measurement of total serum bilirubin (TSB) before phototherapy. Its use during and after phototherapy is not advised yet because of unknown reliability. OBJECTIVES To determine the agreement of TcB and TSB measurements before, during, and after phototherapy. DATA SOURCES PubMed Medline, Cochrane Library, and references of eligible studies were searched. STUDY SELECTION Prospective and retrospective cohort and cross-sectional studies reporting Bland-Altman statistics of paired TcB and TSB measurements in term and preterm newborns. DATA EXTRACTION Meta-analysis was performed using the Mantel-Haenszel weighted approach. The agreement between TcB and TSB in μmol/L was described by pooled mean differences (MDs) and limits of agreement (LoA). RESULTS Fifty-four studies were included. The pooled MD before phototherapy is 2.5 μmol/L (LoA -38.3 to 43.3). The pooled MD during phototherapy is -0.3 μmol/L (LoA -34.8 to 34.2) on covered skin and -28.6 μmol/L (LoA -105.7 to 48.5) on uncovered skin. The pooled MD after phototherapy is -34.3 μmol/L (LoA -86.7 to 18.1) on covered skin and -21.1 μmol/L (LoA -88.6 to 46.4) on uncovered skin. Subgroup analysis revealed the best agreement at the forehead. We did not find any difference in agreement between term and preterm neonates. LIMITATIONS Language restriction. CONCLUSIONS TcB measurements before and during phototherapy on covered skin show good agreement compared with TSB in term and preterm newborns. More studies are needed to evaluate the accuracy after phototherapy.

中文翻译：

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光疗之前、期间和之后的经皮胆红素准确性：荟萃分析。

背景 经皮胆红素测定 (TcB) 被用作有效筛查，以识别在光疗前需要测量血清总胆红素 (TSB) 的新生儿。由于可靠性未知，尚不建议在光疗期间和之后使用它。目的 确定光疗之前、期间和之后 TcB 和 TSB 测量的一致性。数据来源 检索了 PubMed Medline、Cochrane 图书馆和符合条件的研究的参考文献。研究选择 前瞻性和回顾性队列及横断面研究报告了足月和早产新生儿配对 TcB 和 TSB 测量的 Bland-Altman 统计数据。数据提取 使用Mantel-Haenszel 加权方法进行荟萃分析。TcB 和 TSB 之间的一致性（以 µmol/L 为单位）通过合并平均差 (MD) 和一致性限 (LoA) 来描述。结果 纳入了 54 项研究。光疗前的汇总 MD 为 2.5 μmol/L（LoA -38.3 至 43.3）。光疗期间，覆盖皮肤上的汇总 MD 为 -0.3 μmol/L（LoA -34.8 至 34.2），未覆盖皮肤上的汇总 MD 为 -28.6 μmol/L（LoA -105.7 至 48.5）。光疗后，覆盖皮肤上的汇总 MD 为 -34.3 μmol/L（LoA -86.7 至 18.1），未覆盖皮肤上的汇总 MD 为 -21.1 μmol/L（LoA -88.6 至 46.4）。亚组分析揭示了前额的最佳一致性。我们没有发现足月新生儿和早产新生儿之间的一致性存在任何差异。限制 语言限制。结论 足月和早产新生儿的覆盖皮肤光疗前和光疗期间的 TcB 测量结果与 TSB 具有良好的一致性。需要更多的研究来评估光疗后的准确性。