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Updated: Jan 26, 2026

Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Association between neonatal serum bilirubin and childhood obesity in preterm infants
Lijuan Luo1, Lile Zou2, Wenbin Dong1
1Department of Neonatology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Insights
Higher neonatal jaundice levels in preterm infants are linked to an increased risk of childhood obesity. This study suggests a positive association between neonatal total serum bilirubin and later obesity development.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Public Health
Background:
- Adult studies show an inverse relationship between serum bilirubin and obesity.
- The association between neonatal jaundice and childhood obesity in preterm infants remains under-explored.
Purpose of the Study:
- To investigate the association between neonatal jaundice and obesity at age 7 years in preterm infants.
- To determine if higher neonatal bilirubin levels predict increased risk of childhood obesity.
Main Methods:
- Utilized data from the US Collaborative Perinatal Project.
- Employed logistic regression and generalized estimating equation (GEE) models to analyze neonatal total serum bilirubin (TSB) as an exposure factor for obesity.
- Controlled for potential confounders and corrected for intracluster correlation.
Main Results:
- 865 of 5019 preterm infants were obese at age 7.
- A 1 mg/dl increase in neonatal TSB was associated with a 0.03 kg/m² increase in BMI.
- Infants with TSB ≥12 mg/dl had an odds ratio of 1.67 (95% CI 1.22, 2.07) for obesity compared to those with TSB <3 mg/dl.
Conclusions:
- Neonatal bilirubin levels demonstrate a positive association with childhood obesity in preterm infants.
- Elevated neonatal jaundice may be a risk factor for developing obesity in this vulnerable population.
Background:
Serum bilirubin levels are inversely associated with obesity in adults. We are interested in whether neonatal jaundice is associated with childhood obesity in preterm infants.
Methods:
Data were obtained from the US Collaborative Perinatal Project. Neonatal bilirubin levels were used as exposure factors for obesity at age 7 years. Logistic regression models were used to control for potential confounders and calculate odds ratios (ORs). A generalized estimating equation (GEE) model was used to correct for intracluster correlation coefficient. SAS was used for all statistical analyses.
Results:
In the study subjects, 865 of 5019 preterm infants were obese at age 7 years. While neonatal total serum bilirubin (TSB) rose 1 mg/dl, body mass index (BMI) increased 0.03 kg/m2 (95% confidence interval (CI) 0.02, 0.04). Compared with infants with TSB <3 mg/dl, the ORs (95% CIs) for obesity in infants with 3 mg/dl≤ TSB <6 mg/dl, 6 mg/dl≤ TSB <9 mg/dl, 9 mg/dl≤ TSB <12 mg/dl and TSB ≥12 mg/dl were, respectively, 1.18 (0.87, 1.59), 1.25 (0.93, 1.67), 1.52 (1.11, 2.09), and 1.67 (1.22, 2.07). By using subtypes of bilirubin as exposure factors and the GEE model to correct for intracluster correlation coefficient, similar trends of associations were observed.
Conclusion:
Neonatal bilirubin levels have positive trends of associations with childhood obesity in preterm infants.
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