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Factors influencing jaundice follow-up rates in a multi-ethnic Asian population: a cross-sectional study

Sky Wei Chee Koh1,2, Amanda See Wei Teng3, Eldina Rui Qin Ho2

  • 1National University Polyclinics, Singapore sky_wc_koh@nuhs.edu.sg.

BMJ Paediatrics Open
|January 6, 2026
PubMed

Insights

A risk-stratified approach to neonatal jaundice monitoring can optimize follow-up care for newborns. This strategy could safely reduce unnecessary jaundice visits, particularly for normal-risk infants.

Area of Science:

  • Neonatal care
  • Pediatric primary care
  • Public health

Background:

  • Neonatal jaundice is common, requiring careful monitoring to prevent severe hyperbilirubinemia.
  • Current follow-up protocols may not be optimally tailored to individual infant risk levels.
  • Optimizing jaundice monitoring is crucial for efficient primary care resource allocation.

Purpose of the Study:

  • To identify factors influencing neonatal jaundice monitoring in primary care.
  • To evaluate the effectiveness of a risk-stratified approach for jaundice follow-up.
  • To optimize jaundice care for normal-risk newborns.

Main Methods:

  • Cross-sectional study involving 5391 healthy newborns with jaundice at hospital discharge.
  • Data collected from seven primary care clinics in Singapore.
  • Analysis of jaundice visit rates within 90 days postdischarge.

Main Results:

  • Normal-risk newborns had fewer jaundice visits and lower rates of reaching phototherapy thresholds compared to high-risk infants.
  • Factors such as ethnicity (Chinese) and sex (male) were associated with higher follow-up rates.
  • Higher birth weight and normal-risk status were linked to lower follow-up rates.
  • A risk-based approach could have potentially reduced follow-up visits by 16.6% for normal-risk newborns over 7 days old.

Conclusions:

  • Jaundice follow-up visit rates are influenced by various factors, including infant risk stratification.
  • Implementing a risk-stratified approach to jaundice monitoring shows promise for optimizing follow-up care.
  • Further research is recommended to validate and implement this approach in clinical practice.
Abstract

Keywords:
Health services researchJaundiceNeonatology

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