Tham EH, Loo EXL, Goh A, et al. Phototherapy for neonatal hyperbilirubinemia and childhood eczema, rhinitis and wheeze. Pediatr Neonatol. 2019;60(1):28‐34. doi:10.1016/j.pedneo.2018.03.004
Abstract:
Background:
The pathogenesis of allergic diseases in childhood may be attributed to influences of early environmental stimuli on fetal and neonatal immune regulation. Neonatal hyperbilirubinemia is common in the Asian population and up to 20% of infants require phototherapy.
We examined the hypothesis that phototherapy for neonatal hyperbilirubinemia modulates the infant's risk of developing eczema, rhinitis and wheeze in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort.
Method:
Interviewers collected information on demographics, lifestyle, birth data and allergic outcomes. Atopic sensitization was assessed through skin prick testing (SPT) to aeroallergens and food allergens.
Results:
A total of 135 (12.8%) children underwent phototherapy for neonatal hyperbilirubinemia. Infants who underwent phototherapy were of a significantly lower mean (SD) gestational age [37.5 (2.5) weeks] compared to those who did not [38.5 (1.2) weeks p < 0.01]. A higher proportion of infants born by Caesarean section underwent phototherapy compared to those who were born vaginally (17.5% vs 10.7%, p < 0.01). There were no differences in prevalence of allergen sensitization, eczema, rhinitis and early onset wheeze with use of nebulizer in the first 5 years of life between subjects that underwent phototherapy and those that did not. There were also no associations between mean bilirubin peak levels within the phototherapy group with development of eczema, rhinitis and early onset wheeze in the first 5 years of life.
Conclusion:
We found no evidence for a link between phototherapy for neonatal hyperbilirubinemia and childhood allergic outcomes in this prospective mother-offspring cohort.
License type:
http://creativecommons.org/licenses/by-nc-nd/4.0/
Funding Info:
This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC) , Singapore- NMRC/TCR/004-NUS/2008 ; NMRC/TCR/012-NUHS/2014 . This work is also supported by the National Medical Research Council , NMRC/CSA/022/2010 and NRF370062-HUJ-NUS (Project 10). Additional funding is provided by the Singapore Institute for Clinical Sciences , Agency for Science Technology and Research (A*STAR) , Singapore. KMG is funded by the NIHR through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Programme ( FP7/2007-2013 ), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977.