JMIR Publications

ABSTRACT

Background:

Premature birth and neonatal hyperbilirubinemia remain significant contributors to neonatal morbidity and mortality, particularly in low- and middle-income settings where access to advanced neonatal care equipment is limited. Conventional phototherapy units, incubators, and bilirubin meters are often deployed as stand-alone devices, increasing cost, space requirements, and clinical workload while limiting continuous monitoring.

Objective:

This study aimed to design, fabricate, and evaluate a low-cost phototherapeutic infant incubator integrated with a transcutaneous bilirubin detector for continuous thermal, environmental, and bilirubin monitoring in preterm neonates.

Methods:

A user-centered engineering design approach was adopted. System modeling and circuit simulation were carried out using Proteus, while mechanical housing design was performed with SolidWorks. Control logic was implemented on an Arduino Mega 2560 microcontroller, with calibration and reference testing supported using Arduino Uno. The system integrates LED-based phototherapy, a 500 W heating element for thermal regulation, a liquid crystal display for real-time visualization, and a transcutaneous bilirubin sensing module. Temperature and relative humidity were monitored using a DHT22 sensor. Functional performance testing was conducted at a tertiary healthcare facility by comparing device outputs with standard clinical reference instruments. Agreement and correlation analyses were performed to assess accuracy.

Results:

Result showed a strong correlation between the designed device and reference instruments for temperature (R² = 0.86), humidity (R² = 0.91), and transcutaneous bilirubin measurement (R² = 0.88). Bland–Altman analysis of bilirubin measurements showed a mean bias of 0.62 ± 0.99 µmol/L, indicating good agreement within clinically acceptable limits. The integrated system maintained safe thermal conditions and consistent phototherapy delivery throughout testing.

Conclusions:

The phototherapeutic infant incubator with integrated transcutaneous bilirubin detection demonstrated satisfactory accuracy, safety, and reliability. By combining incubation, phototherapy, and bilirubin monitoring into a single platform, the device offers a cost-effective and space-efficient solution for neonatal care, particularly in resource-constrained settings. Its ability to provide continuous, non-invasive bilirubin monitoring may enhance early clinical decision-making and improve outcomes in preterm infants.