Neonatal jaundice in Asian, white, and mixed-race infants.
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.


OBJECTIVE
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.


METHODS
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.
Setia
Sabeena
S
Department of Epidemiology, University of Washington School of Public Health and Community, Seattle, WA, USA.
Villaveces
Andrés
A
Dhillon
Preet
P
Mueller
Beth A
BA
D000328:Adult; D044466:Asian People; D015331:Cohort Studies; D016001:Confidence Intervals; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008423:Maternal Age; D010290:Parents; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014861:Washington / Q000453:epidemiology; D044465:White People