Bentz Michael G, Carmona Nancy, Bhagwat Manavi M, Thimmig Lindsay M, Saleh Jamal, Eke Uchechukwu, Kokroko Jolene, Dadasovich Rand, Rice Brooke, Cabana Michael D
Departments of Pediatrics and.
Departments of Pediatrics and
Hosp Pediatr. 2018 May;8(5):269-273. doi: 10.1542/hpeds.2017-0234. Epub 2018 Apr 4.
Clinical practice guidelines have recognized "Asian" and "East Asian" as risk factors for newborn jaundice and readmission. We sought to identify more detailed and specific, parent-identified races or ethnicities associated with jaundice readmission.
We conducted a case control study of 653 newborn infants born (2014-2016) at a West-Coast, urban hospital to examine specific parent-described races or ethnicities that are associated with newborn hospital readmissions for hyperbilirubinemia. Parent-reported race or ethnicity was abstracted from the California Newborn Screening Test.
Our sample included 105 infants readmitted for jaundice (cases) and 548 infants as controls. In the full cohort, 66 infants (10.1%) were Coombs positive, 39 infants (6.0%) were born before 37 weeks' gestational age, and 405 infants (62.0%) were born to first-time mothers. The parents described the 653 infants using 45 unique races and ethnicities. In a multivariable model that controlled for Coombs positivity, gestational age <37 weeks, and primiparity, infants described as "Far East Asian" (odds ratio [OR] = 3.17; 95% confidence interval [CI] = 1.94-5.18) or "Southeast Asian" (OR = 3.17; 95% CI = 1.66-6.08) had increased risk for jaundice readmission. Infants described as Southeast Asian (eg, Laotian, Cambodian, Indonesian, Vietnamese, and Filipino) and Far East Asian (eg, Chinese, Korean, Taiwanese, Japanese, and Mongolian) had an increased risk of readmission. Finally, we did not find an association between South Asian (OR = 0.79; 95% CI = 0.33-1.92) race or ethnicity and risk of jaundice readmission.
In this study, we help clarify and move beyond the term "Asian" as a risk factor for readmission due to hyperbilirubinemia.
临床实践指南已将“亚洲人”和“东亚人”视为新生儿黄疸及再次入院的风险因素。我们试图确定与黄疸再次入院相关的更详细、更具体的、由父母确定的种族或族裔。
我们对一家西海岸城市医院（2014 - 2016年）出生的653名新生儿进行了病例对照研究，以检查与高胆红素血症导致的新生儿再次入院相关的特定父母描述的种族或族裔。父母报告的种族或族裔信息取自加利福尼亚新生儿筛查测试。
我们的样本包括105名因黄疸再次入院的婴儿（病例组）和548名作为对照组的婴儿。在整个队列中，66名婴儿（10.1%）库姆斯试验呈阳性，39名婴儿（6.0%）在孕37周前出生，405名婴儿（62.0%）为初产妇所生。父母用45种独特的种族和族裔描述了这653名婴儿。在一个控制了库姆斯试验阳性、孕周<37周和初产情况的多变量模型中，被描述为“远东亚洲人”（比值比[OR]=3.17；95%置信区间[CI]=1.94 - 5.18）或“东南亚人”（OR = 3.17；95% CI = 1.66 - 6.08）的婴儿黄疸再次入院风险增加。被描述为东南亚人（如老挝人、柬埔寨人、印度尼西亚人、越南人和菲律宾人）和远东亚洲人（如中国人、韩国人、台湾人、日本人、蒙古人）的婴儿再次入院风险增加。最后，我们未发现南亚种族或族裔（OR = 0.79；95% CI = 0.33 - 1.92）与黄疸再次入院风险之间存在关联。
在本研究中，我们有助于澄清并超越将“亚洲人”作为高胆红素血症导致再次入院的风险因素这一表述。
