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Neonatal jaundice in Asian, white, and mixed-race infants
Sabeena Setia1, Andrés Villaveces, Preet Dhillon
1Department of Epidemiology, University of Washington School of Public Health and Community, Seattle, WA, USA.
Insights
Neonatal jaundice diagnoses are more common in East Asian and mixed infants. However, only full East Asian infants showed an increased risk for severe jaundice requiring significant medical intervention.
Area of Science:
- Neonatal Medicine
- Pediatrics
- Public Health
Background:
- East Asian infants naturally have higher bilirubin levels at birth than white infants.
- Neonatal jaundice poses public health and clinical significance due to potential overtreatment.
Purpose of the Study:
- To analyze neonatal jaundice diagnoses in East Asian and mixed East Asian/white infants in Washington State.
- To compare the risk of neonatal jaundice diagnosis in these infants relative to white infants.
Main Methods:
- Population-based cohort study in Washington State.
- Included infants of full East Asian, maternal Asian, paternal Asian, and white parentage.
- Used International Classification of Diseases, Ninth Revision (ICD-9) codes from hospital discharge records to identify jaundice diagnoses.
Main Results:
- Infants of full East Asian parentage had a higher likelihood of jaundice diagnosis (RR, 1.37) compared to white infants.
- Mixed East Asian/white infants showed varied risks: maternal Asian (RR, 1.09) and paternal Asian (RR, 1.26).
- Only infants of full East Asian parentage had a significantly elevated risk of severe jaundice requiring phototherapy, transfusion, or rehospitalization (RR, 1.7).
Conclusions:
- Neonatal jaundice diagnoses were more frequent in East Asian and mixed East Asian/white infants.
- The risk for severe jaundice requiring intensive medical care was elevated solely among infants of full East Asian parentage.
Background:
East Asians have inherently higher bilirubin levels at birth than whites. The potential for unnecessary treatment makes jaundice a problem of public health and clinical significance.
Objectives:
To report the occurrence of jaundice diagnoses in East Asian and mixed East Asian/white infants in Washington State in recent years, and to compare the risk of diagnosis with neonatal jaundice among these infants, relative to white infants.
Design:
Population-based cohort study in Washington state. Participants were infants of full East Asian parentage (n = 3000), maternal Asian parentage (n = 2997), paternal Asian parentage (n = 2048), and white parentage (n = 3000). Diagnoses of jaundice and "severe jaundice" were identified using International Classification of Diseases, Ninth Revision (ICD-9) diagnosis and procedure codes from hospital discharge records.
Results:
Infants of full East Asian parentage were more likely to be diagnosed with jaundice than were white infants (relative risk [RR], 1.37; 95% confidence interval [CI], 1.16-1.62). For infants with Asian mothers and white fathers, the RR was 1.09 (95% CI, 0.91-1.30). Infants with Asian fathers and white mothers had an RR of 1.26 (95% CI, 1.05-1.52). The risk of severe jaundice requiring phototherapy, blood transfusion, or rehospitalization, however, was significantly elevated only for infants of full East Asian parentage (RR, 1.7; 95% CI, 1.12-2.58).
Conclusions:
Diagnoses of neonatal jaundice occurred more often among East Asian and mixed Asian/white infants than among white infants. However, the risk of jaundice requiring extended hospital stay, rehospitalization, phototherapy, or blood transfusion was elevated only for infants of full East Asian parentage.