The increase of yellow skin colour beyond that of serum bilirubin: A proposed indicator of risk for bilirubin encephalopathy in the newborn

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Abstract
Forty‐seven newborn infants with 1 min Apgar score < 7 were studied. On the third postnatal day the following measurements were made: yellow skin colour, serum bilirubin concentration, reserve albumin concentration and plasma pH. Given the bilirubin concentration and the regression curve between the yellow skin colour and the bilirubin concentration, Δ‐TcB was calculated as the difference between measured yellow skin colour and the expected yellow skin colour. There was a negative correlation between Δ‐TcB and Apgar score (P = 0.003), pH (P = 0.026) and reserve albumin concentration (P = 0.045). Fourteen of the included newborns had central nervous system symptoms in the days just following birth. A tendency towards higher Δ‐TcB was noted in this group (P = 0.08). The results suggest that further study of Δ‐TcB determination as a tool in the assessment of the icteric newborn infant is justified.