Neonatal Jaundice Linked to Higher Risk of Childhood Asthma, New Study Finds
Sweden: New evidence suggests that infants with neonatal jaundice, whether treated with phototherapy or not, may face an increased risk of developing asthma during childhood. The findings, published in Pediatric Allergy and Immunology, highlight the possible long-term respiratory consequences of early-life conditions.
The study, led by Dr. Sara Aspberg and colleagues from the Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, explored whether neonatal phototherapy or jaundice (neonatal icterus) influences the likelihood of asthma later in life.
The research team utilized the Swedish Medical Birth Register and linked it with the Swedish Prescribed Drug Register to track anti-asthmatic medication use among children. The study population included over 1.33 million singleton children born in Sweden between January 1990 and June 2003, of whom more than 61,000 were prescribed asthma medication before the age of 12.
Key Findings:
- Neonatal phototherapy and/or jaundice were confirmed as significant risk factors for childhood asthma, even after adjusting for multiple maternal and perinatal factors such as maternal smoking, diabetes, pre-eclampsia, advanced maternal age, mode of delivery, prematurity, low birth weight, and neonatal complications.
- Children exposed to neonatal phototherapy or jaundice had an odds ratio (OR) of 1.30 for developing asthma.
- The risk of asthma was elevated in both treated infants (OR 1.18) and those with untreated jaundice (OR 1.12).
- A modest association was observed between treated children and allergic rhinitis (OR 1.08).
- No significant link was found between neonatal phototherapy or jaundice and atopic dermatitis.
“These findings strengthen previous evidence that jaundice severity and its management in the neonatal period may play a role in shaping allergic disease susceptibility in early life,” the authors noted.
Beyond jaundice, the study also identified several other perinatal and maternal factors tied to an increased risk of asthma. First-born children, those born preterm or with low birth weight, infants requiring respiratory support, and those exposed to maternal smoking or advanced maternal age were more likely to need asthma medication during childhood.
The results add to ongoing discussions about the role of early-life exposures in the development of chronic respiratory and allergic conditions. While phototherapy remains a widely used and often necessary treatment for neonatal jaundice, the study suggests clinicians and parents should remain aware of its potential long-term associations.
Importantly, the researchers emphasized that their findings do not suggest avoiding phototherapy when clinically indicated. Instead, they highlight the importance of continued follow-up and monitoring of children with a history of neonatal jaundice, particularly those requiring phototherapy.
"The large-scale population-based study confirms that neonatal phototherapy and neonatal jaundice are linked to a heightened risk of asthma in childhood, adding to the growing evidence that perinatal factors influence long-term respiratory health," the authors concluded.
Reference:
Aspberg, S., Dahlquist, G., Kahan, T., & Källén, B. (2010). Confirmed association between neonatal phototherapy or neonatal icterus and risk of childhood asthma. Pediatric Allergy and Immunology, 21(4p2), e733-e739. https://doi.org/10.1111/j.1399-3038.2010.01038.x
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