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Multicenter Study
. 2013 Dec 15;178(12):1691-7.
doi: 10.1093/aje/kwt248. Epub 2013 Oct 31.

Neonatal bilirubin levels and childhood asthma in the US Collaborative Perinatal Project, 1959-1965

Lisu Huang, Yixiao Bao, Zongli Xu, Xiaoping Lei, Yan Chen, Yongjun Zhang, Jun Zhang
Multicenter Study

Neonatal bilirubin levels and childhood asthma in the US Collaborative Perinatal Project, 1959-1965

Lisu Huang et al. Am J Epidemiol. .

Abstract

Evidence shows that asthma originates in early life. Studies have found that phototherapy and/or neonatal jaundice may be associated with asthma. We investigated the association between neonatal bilirubin levels and childhood asthma without phototherapy intervention in the Collaborative Perinatal Project, a multicenter prospective cohort study conducted in the United States from 1959 to 1965. A total of 54,795 livebirths were included, and 40,063 children were followed up until 7 years of age or older. Total serum bilirubin (TSB) levels were examined at 48 hours postpartum in newborns with birthweights of 2,250 g or more. Information on asthma and other diseases through age 7 years was summarized and confirmed by a group of pediatricians and child neurologists. Among 28,807 term infants, the overall prevalence of asthma was 5.26%. Risks of asthma increased with both maximum TSB levels and TSB levels at 48 hours postpartum (P for trend < 0.01). Neonatal maximum TSB levels greater than 15 mg/dL were associated with a 61% increase in the risk of childhood asthma (odds ratio = 1.61, 95% confidence interval: 1.04, 2.08) after adjustment for confounders. In this prospective cohort study of infants born at a time when phototherapy was unavailable, neonatal hyperbilirubinemia was associated with an increased risk of childhood asthma.

Keywords: asthma; bilirubin; immaturity; perinatal exposure; phototherapy.

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Figures

Figure 1.
Figure 1.
Study population flow chart, Collaborative Perinatal Project, United States, 1959–1965.
Figure 2.
Figure 2.
Prevalence distribution of neonates by maximum total serum bilirubin levels, Collaborative Perinatal Project, United States, 1959–1965.
Figure 3.
Figure 3.
Prevalence of asthma by total serum bilirubin level, Collaborative Perinatal Project, United States, 1959–1965. Total serum bilirubin level at 48 hours postpartum (left panel) and maximum total serum bilirubin (right panel).
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