Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Does skin pigmentation affect serum bilirubin estimation?

Pediatric Research (2025)Cite this article

Bokser et al.1 have applied advanced technologies to evaluate neonatal skin pigmentation in Kenya and proposed that the intensity of pigmentation must be considered in designing transcutaneous diagnostic tests for plasma bilirubin and oxyhemoglobin saturation. They observed 1) considerable heterogeneity of skin tone at birth even within an ethnically homogenous black population and 2) significant darkening of skin during the first month of life; light reflectance decreased at both wavelength 550 nm (oxyhemoglobin) and 460 nm (maximum absorption for bilirubin). They argue that the failure of reflectance to increase at 460 nm (expected as the serum bilirubin decreased) must be due to an increase in melanin. However, the reported transcutaneous bilirubin assay, which is also reflectance-based, decreased as expected. An even greater 1-month decline in percent reflectance was observed at 550 nm, but melanin has little absorbance at this wavelength.

The study has some shortcomings, acknowledged in part by the authors, regarding the metrology. It would have been advantageous to have had repeated measurements of skin reflectance performed at multiple sites. It is expected that there is a significant variability inherent to the measurement process since the skin coloration may not be uniform, and the contact between the measurement instrument and the skin may also lead to variations. The reported instrument repeatability as provided by the manufacturer has only limited value in this regard.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Bokser S, Koech P, Bosuben H, Gaichiumia A, Miwa A, Wanyoro A. Skin reflectance changes in Kenyan neonates during the first month of life: an observational study. Pediatr. Res. https://doi.org/10.1038/s41390-025-04079-w (2025).

Download references

Author information

Authors and Affiliations

  1. University of California Davis, Sacramento, CA, USA

    Richard P. Wennberg

  2. University of Washington School of Medicine, Seattle, WA, USA

    Richard P. Wennberg

  3. Norwegian University of Science and Technology, Oppland, Gjøvik, Norway

    Jon Yngve Hardeberg

Authors
  1. Richard P. Wennberg
    View author publications

    Search author on:PubMed Google Scholar

  2. Jon Yngve Hardeberg
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Richard P. Wennberg.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wennberg, R.P., Hardeberg, J.Y. Does skin pigmentation affect serum bilirubin estimation?. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04406-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41390-025-04406-1

Search

Advanced search

Quick links