Phototherapy and risk of developmental delay: the Japan Environment and Children's Study
Masashi Hotta1, Kimiko Ueda2, Satoyo Ikehara3,4
1Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.
Insights
Longer phototherapy for neonatal jaundice may predict developmental delays in children. Limiting phototherapy duration is crucial to mitigate potential risks for infant development.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Public health
Background:
- Phototherapy is a standard treatment for neonatal jaundice, with known short- and long-term complications.
- Previous research has not conclusively linked phototherapy duration to developmental delay prevalence in large-scale studies.
Purpose of the Study:
- To investigate the association between the duration of phototherapy for neonatal jaundice and the risk of developmental delay at three years of age.
- To analyze nationwide birth cohort data to understand this relationship.
Main Methods:
- An observational cohort study involving 76,897 infants.
- Infants were categorized into four groups based on phototherapy duration: none, short (1-24h), long (25-48h), and very long (>48h).
- Developmental delay was assessed at age 3 using the Japanese version of the Ages and Stages Questionnaire-3 (ASQ-3), with logistic regression analysis employed.
Main Results:
- A significant dose-response relationship was observed between phototherapy duration and ASQ-3 scores across four developmental domains.
- Increased odds of communication delay were associated with short, long, and very long phototherapy durations (ORs 1.10, 1.32, 1.48).
- Significant associations were also found for gross motor, problem-solving, and personal-social domains, with the highest odds ratio for personal-social delay in the very long phototherapy group (OR 1.84).
Conclusions:
- Extended phototherapy duration is a predictive factor for developmental delay at three years of age.
- Avoiding prolonged phototherapy is important for infant development.
- Further research is needed to clarify whether longer phototherapy duration directly increases the prevalence of developmental delay.
Abstract:
This observational cohort study aimed to examine the association between the duration of phototherapy for neonatal jaundice and the risk of developmental delay at 3 years of age using nationwide birth cohort data. Data from 76,897 infants were analyzed. We divided participants into four groups: no phototherapy, short phototherapy (1-24 h), long phototherapy (25-48 h), and very long phototherapy (> 48 h). The Japanese version of the Ages and Stages Questionnaire-3 was used to evaluate the risk of developmental delay at 3 years of age. Logistic regression analysis was performed to assess the impact of phototherapy duration on the prevalence of developmental delay. After adjustment for potential risk factors, a dose-response relationship was identified between the duration of phototherapy and Ages and Stages Questionnaire-3, and the differences were significant in four domains; odds ratio for communication delay was associated with short, long, and very long phototherapy = 1.10 (95% confidence interval 0.97-1.26), 1.32 (1.04-2.66), and 1.48 (1.11-1.98), respectively; for gross motor delay = 1.01 (0.89-1.15), 1.28 (1.03-2.58), and 1.26 (0.96-1.67); for problem solving delay = 1.13 (1.03-1.25), 1.19 (0.99-1.43), and 1.41 (1.11-1.79); and for personal social delay = 1.15 (0.99-1.32), 1.10 (0.84-1.44), and 1.84 (1.38-2.45).
Conclusion:
Longer duration of phototherapy is a predictive factor for developmental delay, making it important to avoid extended periods of phototherapy. However, whether it increases the prevalence of developmental delay remains unclear.
What Is Known:
• Phototherapy is a common treatment for neonatal jaundice, associated with both short-term and long-term complications. • However, an association between phototherapy and the prevalence of developmental delay has not been revealed in a large cohort study.
What Is New:
• We identified that a long duration of phototherapy was a predictive factor for developmental delay at 3 years of age. • However, whether a long duration of phototherapy increases the prevalence of developmental delay remains unclear.
