ArticleBMJ paediatrics open2026
Factors influencing jaundice follow-up rates in a multi-ethnic Asian population: a cross-sectional study.
Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the factors affecting neonatal jaundice monitoring in primary care, specifically in normal-risk newborns, with the aim of optimising jaundice follow-up care through a risk-stratified approach.
designCross-sectional study.
settingSeven primary care clinics in Singapore. PATIENTS: 5391 healthy newborns with jaundice at hospital discharge.
main outcome measuresJaundice visit rates within 90 days postdischarge.
results5391 newborns attended 26 494 jaundice visits between 2022-2023, with 4593 (85.2%) determined to be normal-risk for severe hyperbilirubinaemia. compared with high-risk newborns, normal-risk newborns had significantly fewer visits (five visits, IQR 2-7 vs five visits, IQR 4-7), higher birth weight (3.13 kg, SD 0.47 vs 2.94 kg, SD 0.43), fewer newborns reaching phototherapy thresholds (8.4% vs 27.9%), and lower jaundice discharge rate (71.4% vs 75.6%). Chinese (compared with Malay) (incidence rate ratio (IRR) 1.15, 95% CI 1.11 to 1.19) and male (IRR 1.10, 95% CI 1.07 to 1.13) newborns had higher follow-up rates, while higher birth weight (IRR 0.752, 95% CI 0.728 to 0.778) and normal-risk (compared with high risk) (IRR 0.93, 95% CI 0.90 to 0.97) were associated with lower follow-up rates. Among normal-risk newborns >7 days old, none exceeded phototherapy thresholds; a risk-based approach could have safely avoided 3652 out of 22 053 follow-up visits (16.6%) in this group.
conclusionOur study provides insights into factors influencing jaundice follow-up visit rates. A risk-stratified approach to jaundice monitoring may optimise follow-up care. Further study is needed to implement and evaluate its effectiveness.
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