Abstract
Prolonged jaundice is a commonly evaluated condition. The aim of this study was to assess the risk factors of jaundice in healthy infants at one month of age. This prospective cohort study enrolled 509 healthy infants from 2013 to 2018. Those with gestational age (GA) less than 35 weeks, birth weight less than 2000 grams, and illness were not enrolled. Jaundice was defined as a transcutaneous bilirubin value ≥5 mg/dL at 25–45 days of age. Umbilical cord blood samples were obtained to examine seven common gene variants. The incidence of prolonged jaundice was 32.2%. Prolonged jaundice was more common in infants with exclusive breastfeeding (p < 0.001), GA 35~37 w (p = 0.001), stool passage >4 times/d (p < 0.001), previous phototherapy (p < 0.001), and gene variant of G to A at nt 211 of UGT1A1 (p = 0.004). A multivariate logistic regression analysis demonstrated the greatest risk for prolonged jaundice was exclusive breastfeeding (OR = 2.818, 95% CI = 1.851–4.292), followed by previous phototherapy (OR = 2.593, 95% CI = 1.716–3.919), GA 35~37 w (OR = 2.468, 95% CI = 1.350–4.512), and G to A at nt 211 of UGT1A1 (OR = 1.645, 95% CI = 1.070–2.528). In conclusion, infants with exclusive breastfeeding, GA 35~37 w, previous phototherapy, or G to A at nt 211 of UGT1A1 are at greater risk of prolonged jaundice. Healthcare professionals should consider these risk factors in their assessment of prolonged jaundice.
Highlights
Neonatal jaundice is associated with a variety of physiologic and pathologic conditions[1]
In this prospective cohort survey, we examined the clinical manifestations and genetic variants of one-month-old infants to verify their correlation with prolonged jaundice
Of the 589 infants, 509 infants were eligible for enrollment into this study at 25 to 45 days of age, including 164 with jaundice (TcB value ≥ 5 mg/dL) and 345 without jaundice (TcB value < 5 mg/dL)
Summary
Neonatal jaundice is associated with a variety of physiologic and pathologic conditions[1]. Prolonged jaundice, defined as visible jaundice beyond 14 days, is one of the most commonly evaluated conditions during neonatal and young infant period in Asian population[8] It can be a sign of a serious underlying pathology. Many studies have documented the strong association between breast milk jaundice and gene variants of TA repeat or nucleotide (nt) 211 in UGT1A1 promoter[8,10,11]. A large-scale comprehensive approach to investigate the risk of prolonged jaundice in healthy infants is lacking. In this prospective cohort survey, we examined the clinical manifestations and genetic variants of one-month-old infants to verify their correlation with prolonged jaundice
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