Neonatal jaundice, phototherapy and childhood allergic diseases: An updated systematic review and meta‐analysis
- 21 January 2021
- journal article
- review article
- Published by Wiley in Pediatric Allergy and Immunology
- Vol. 32 (4), 690-701
- https://doi.org/10.1111/pai.13456
Abstract
Background Neonatal jaundice and phototherapy have been associated with the development of allergic diseases. It has been suggested, however, that effect estimates of the associations might be smaller than expected. We sought to update the evidence of their associations including recently published large longitudinal studies. Methods We sought published and unpublished observational studies through the major databases. We used a random‐effect meta‐analysis model weighted by the inverse variance estimate, the Quality in Prognosis Studies tool to assess the methodological quality for each study, and the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess the certainty of evidence (COE). Results Nineteen studies were enrolled in the qualitative syntheses, and fourteen studies were synthesized in the meta‐analyses. Neonatal jaundice was associated with a higher risk of childhood‐onset asthma (odds ratio [OR], 1.46; 95% confidence interval [95% CI], 1.39‐1.53; COE, moderate), atopic dermatitis (AD; OR, 1.30; 95% CI, 1.07‐1.57; COE, moderate), and allergic rhinitis (AR; OR, 3.01; 95% CI, 0.8810.30; COE, low). Neonatal phototherapy was also associated with a higher risk of childhood‐onset asthma (OR, 1.24; 95% CI, 1.11‐1.38; COE, moderate), AD (OR, 1.31; 95% CI, 1.24‐1.39; COE, moderate), and AR (OR, 1.38; 95% CI, 0.93‐2.04; COE, very low). There were no studies that reported effect estimates of the associations between childhood‐onset food allergies and neonatal jaundice and phototherapy. Conclusion Neonatal jaundice and phototherapy were probably a prognostic factor of childhood‐onset allergic diseases; however, the associations were likely to be smaller than previously estimated.Keywords
This publication has 46 references indexed in Scilit:
- Neonatal Jaundice is a Risk Factor for Childhood Allergic Rhinitis: A Retrospective Cohort StudyAmerican Journal of Rhinology and Allergy, 2013
- The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: A global synthesisAllergologia et Immunopathologia, 2012
- The side effects of phototherapy for neonatal jaundice: what do we know? What should we do?European Journal of Pediatrics, 2011
- Determinants of eczema: population-based cross-sectional study in GermanyAllergy, 2010
- Confirmed association between neonatal phototherapy or neonatal icterus and risk of childhood asthmaPediatric Allergy and Immunology, 2010
- Use of Phototherapy for Neonatal Hyperbilirubinemia Affects Cytokine Production and Lymphocyte SubsetsNeonatology, 2008
- Neonatal hyperbilirubinemia increases intestinal protein permeability and the prevalence of cow's milk protein intoleranceActa Paediatrica, 2008
- Is neonatal phototherapy associated with an increased risk for hospitalized childhood bronchial asthma?Pediatric Allergy and Immunology, 2007
- Association between asthma and rhinitis according to atopic sensitization in a population-based studyJournal of Allergy and Clinical Immunology, 2004
- Intracellular accumulation of unconjugated bilirubin inhibits phytohemagglutinin-induced proliferation and interleukin-2 production of human lymphocytesDigestive Diseases and Sciences, 1996