Air & Water Borne Diseases
Open Access

Neonatal jaundice; Serum bilirubin; Air pollutant; Prenatal trimester

Introduction

Air pollution has been linked to a number of respiratory diseases, including Chronic Obstructive Pulmonary Disease (COPD), asthma, lung cancer an increased risk of death. Pollution of the environment is especially harmful to pregnant women, developing fetuses, and newborn. Exposure to air pollution has been linked to a growing number of negative outcomes for newborns, including low birth weight, elevated systolic blood pressure, and mortality. Neonatal jaundice is the most widely recognized clinical issue of babies. The most common cause of newborn re-hospitalization, cerebral palsy, the pathogenesis of deafness is severe neonatal jaundice that progresses to acute bilirubin cephalopathy and kernicterus. The clinical and public health significance of neonatal jaundice as an important neonatal condition that warrants global health attention in the post 2015 millennium development goals era has been increasingly recognized by the leading health care policy research groups, such as the Child Health Epidemiology Reference Group of the World Health Organization (WHO) and the Global Burden of Disease Collaborators. Intrauterine retardation, gestational diabetes, sepsis, intrauterine infections, pregnancy anemia, and congenital hypothyroidism are all known risk factors for neonatal jaundice. Environmental tobacco smoke exposure is known to increase the risk of neonatal jaundice in pregnant women. Nonetheless, the relationship between's air quality and the neonatal jaundice risk remains quantified. This study aims to determine the magnitude and mechanisms of the potential effects of exposure to air pollution on the risk of neonatal jaundice [1-5].

Methods of patients associated study

The risk of neonatal jaundice is influenced, respectively, by the duration of neonatal exposure to air pollution, the concentration of air pollutants to which newborns were exposed, and maternal exposure to air pollution during the third trimester of pregnancy. After controlling for the other two factors, we estimated the sole effect of each factor on neonatal jaundice in this study. After controlling for the other two factors, it was found that the relationship between each factor and neonatal jaundice was very similar to that without controlling for them, indicating that individual factors largely influenced neonatal jaundice independently [6,7].

The newborns in this study population were not exposed to sunlight outside because they spent all of their stay in the wards before being discharged. By stratified analysis of TOA irradiance, It was discovered that the relationship between air pollution exposure and the incidence of neonatal jaundice was unaffected by top of the atmosphere (TOA) incident solar irradiance. Strengthening Table 6 shows that in a dirtied climate (AQI > 100), climatic deceivability was a lot of lower than that under less contaminated conditions (AQI < 100).

Clinical data for the mother and the fetus

From the dataset of 44,029 infants brought into the world in Beijing from June 2014 through May 2017. 2349 of these babies were born too soon, and 14,926 of them were discharged between one and two days after birth because their bilirubin levels were not regularly monitored. The dataset did not include these infants. Likewise eliminated 972 babies who were conceded to the neonatal ward because of neonatal asphyxia, neonatal hemolytic sickness, or neonatal yearning pneumonia. In this study, we ultimately selected 25,782 term singleton newborns without hemolytic disease. Before being released from the hospital, these newborns spent the entirety of their time in the wards [8,9].

The mother's age, occupation, educational level, gravidity, gestational age, pregnancy complications, delivery data (delivery time,delivery mode, postpartum hemorrhage, intrapartum hemorrhage, bleeding reason, and emergency rescue), labor time (I, II, and III, assembly, complications), and other clinical monitoring items (number of white blood cells, neutrophil percentage (GR), umbilical blood flow (S per D), and blood pressure) were all collected for each newborn. Gender, height, weight, the Apgar score, special cases, and the delivery process, such as fetal distress, the umbilical cord, and amniotic fluid, were among the newborn characteristics.

Methodological data

A single station near Beijing's southwest fourth ring road provided us with 3-hourly meteorological data from June 2014 to May 2017. The World Meteorological Organization receives reports on the station's data, which are then stored at the National Centers for Environment Information (NOAA) of the United States National Oceanic and Atmospheric Administration. The visibility of the atmosphere, air temperature (in meters), and relative humidity were recorded every three hours. Because there were too many missing values in the cloud data, they were left out [10].

Discussion

It is examined that at the levels of Alanine Aminotransferase (ALT), Glutamyl Transferase (GGT), and Aspartate Aminotransferase (AST) in 300 of the 25,782 newborns to verify the liver associated route. ALT, AST and GGT can cause unusual liver capability. These 300 babies had exceptionally high aggregate serum bilirubin (TSB) levels in blood (as best quality level for jaundice analysis), and they were hospitalized in the neonatal emergency unit. Among these newborns with severe jaundice, 129 were exposed to air that was more polluted (AQI > 100) and 171 were exposed to air that was less polluted. Although the difference was not statistically significant likely due to the small sample size, Supplementary study reveals that newborns exposed to more severe air pollution (AQI > 100) had higher levels of ALT and GGT. Besides, babies presented to unfortunate air quality had a lot higher AST level than those breathing more clean air. The dissipate plot in Strengthening further demonstrates that the peak bilirubin level among the 300 newborns increased with the AQI (including all pollutants). These findings suggested a significant connection between exposure to air pollution, neonatal liver function, and jaundice [11,12].

Concerns about causal inference were dispelled by this study's estimation of the impact of exposure to air pollution during pregnancy and delivery on the risk of neonatal jaundice. It also provided evidence for the association. To quantify the risk of neonatal jaundice caused by PM2.5, SO2, and CO, including exposure time and average concentration. Individual level variations in maternal pregnancyinduced outcomes like gestational diabetes mellitus, air temperature, and relative humidity are not considered to be confounding factors in our analyses, which reduces concern about these factors. Mothers were exposed to different levels of sunlight during pregnancy, which may confuse the effects of air pollution on maternal exposure because newborns were in the ward and had little exposure to sunlight from outside. Mother's socioeconomic and behavioral characteristics may play a significant role in the risk of neonatal jaundice in addition to environmental factors. We intend to incorporate additional data in subsequent work to investigate the connections [13-15].

Conclusion

There are two aspects to this study that make it significant. First, the link between exposure to air pollution and the risk of neonatal jaundice is not taken into account in the current guidelines for managing hyperbilirubinemia in newborns. The American Association of Pediatrics created a time-bilirubin curve and a jaundice follow-up plan following discharge. They investigated the potential risk factors for neonatal jaundice. But they didn't look at the high risk of neonatal jaundice from being exposed to air pollution. The Society of Pediatrics of the Chinese Medical Association (SPCMA) in China also did not link exposure to air pollution to neonatal jaundice. Our study demonstrates that air pollution exposure is a significant risk factor for neonatal jaundice incidence by analyzing the effects of exposure to air pollution on the incidence of the condition. It can be suggested that the AAP and SPCMA include air pollution exposure as a risk factor for newborn jaundice in the guidelines.

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