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Neonatal Jaundice in Asian, White, and Mixed-Race Infants
Sabeena Setia, MPH;
Andrés Villaveces, MD, PhD;
Preet Dhillon, MPH;
Beth A. Mueller, DrPH
Arch Pediatr Adolesc Med. 2002;156:276-279.
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.
From the Department of Epidemiology, University of Washington School
of Public Health and Community Medicine (Mss Setia and Dhillon and Drs Villaveces
and Mueller); and the Public Health Sciences Division, Fred Hutchinson Cancer
Research Center (Ms Dhillon and Dr Mueller), Seattle, Wash.
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