Neonatal jaundice is a risk factor for childhood asthma: a retrospective cohort study

Authors

  • Min-Sho Ku,

    1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    2. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
    3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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  • Hai-Lun Sun,

    1. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
    2. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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  • Ji-Nan Sheu,

    1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    2. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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  • Hong-Shen Lee,

    1. School of Public Health, Chung Shan Medical University, Taichung, Taiwan
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  • Shun-Fa Yang,

    1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
    2. Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Ko-Huang Lue

    1. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
    2. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Ko-Huang Lue and Shun-Fa Yang, Division of Allergy, Asthma and Rheumatology, Department of pediatrics, Chung Shan Medical University Hospital, No. 110, Sec 1, Chien-Kuo N. Road, 402 Taichung, Taiwan.
Tel.: 886 4 24739595 ext. 34816
Fax: 886 4 24710934
E-mail: ysf@csmu.edu.tw; cshy095@csh.org.tw

Abstract

Background:  The association between neonatal jaundice and childhood asthma is a new finding of two reports. The purpose of the study was to verify their results.

Methods:  Data from 11,321 children were collected from the National Health Insurance Research Database. Their claims data were evaluated from birth to 10 yr old. Children were analyzed as case (those with neonatal jaundice) and controls (those without neonatal jaundice). The diagnostic criteria for asthma were as follows: at least four asthma diagnoses at outpatient services and emergency department (ED), or one asthma diagnosis during an admission. In children fitting the asthma criteria, those with no asthma diagnosis after 1 yr of age were excluded. Mantel–Haenszel’s odds ratios were calculated after adjustment for the following confounders: preterm/low birth weight, neonatal infection, other respiratory conditions, other birth conditions, and gender. Asthma rate, onset time, the use of drugs, upper respiratory infection and lower respiratory infection (LRI) rates, hospital admission/ED visit rates, and the effect of phototherapy were evaluated.

Results:  After adjustment for the confounding factors, the rate of asthma was higher in icteric children (OR: 1.64, 95% CI 1.36–1.98, p < 0.001), and the influence in females was stronger. There still was an association between neonatal jaundice and late onset asthma (asthma onset after 3 yr of age). In asthmatic children, those with neonatal jaundice have increased asthma onset rate before age 6, increased use of inhalant steroids, LRI rates, and ED visits for respiratory disease.

Conclusions:  Neonatal jaundice increased the rate and severity of childhood asthma in subjects aged up to 10 yr and may be a risk factor for childhood asthma.

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