Elizabeth Huiwen Tham1, Evelyn Xiu Ling Loo2, Anne Goh3, Oon Hoe Teoh4, Fabian Yap5, Kok Hian Tan6, Keith M Godfrey7, Hugo Van Bever1, Bee Wah Lee8, Yap Seng Chong9, Lynette Pei-Chi Shek10. 1. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore. 2. Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore. 3. Allergy Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore. 4. Respiratory Service Medicine, Department of Paediatrics, KK Women's and Children's Hospital, Singapore. 5. Department of Endocrinology, KK Women's and Children's Hospital, Singapore. 6. Department of Maternal Fetal Medicine, KK Women's and Children's Hospital (KKH), Singapore. 7. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, SO16 6YD, Southampton, United Kingdom; Medical Research Council Lifecourse Epidemiology Unit, SO16 6YD, Southampton, United Kingdom. 8. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 9. Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. 10. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore. Electronic address: lynette_shek@nuhs.edu.sg.
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. TRIAL REGISTRATION: NCT01174875 Registered 1 July 2010, retrospectively registered.
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. TRIAL REGISTRATION: NCT01174875 Registered 1 July 2010, retrospectively registered.
Authors: V A Vavilin; O G Safronova; A A Lyapunova; V V Lyakhovich; L F Kaznacheeva; N A Manankin; A V Molokova Journal: Bull Exp Biol Med Date: 2003-10 Impact factor: 0.804