{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:07:58Z","timestamp":1793351278669,"version":"4.5.0"},"reference-count":44,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sanming Project of Medicine","award":["SZSM201612018"],"award-info":[{"award-number":["SZSM201612018"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,18]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to assess knowledge, attitudes and practices related to neonatal jaundice among mothers in Shenzhen, China, and analyse associated factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>This study was conducted in Shenzhen Hospital, Southern Medical University, a university-affiliated, tertiary level A, public hospital in China. On average, 4000 mothers are discharged from this hospital after childbirth each year, most of whom can access a mobile phone and the internet.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Participants were 403 mothers discharged from the study hospital within 48\u201372\u2009hours after vaginal delivery or 96\u2013120\u2009hours after caesarean delivery between April and June 2021. Participants were recruited using convenience sampling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome<\/jats:title>\n                  <jats:p>Mothers\u2019 knowledge, attitudes and practices related to neonatal jaundice, modelled using binary logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Secondary outcomes<\/jats:title>\n                  <jats:p>Factors associated with mothers\u2019 knowledge, attitudes and practices related to neonatal jaundice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The questionnaire was reliable (Cronbach\u2019s alpha=0.802) and valid (scale-level content validity index=0.958). The valid response rate was 96.4%. Only 46.4% of participating mothers had good knowledge about neonatal jaundice and 41.7% indicated they would seek information about neonatal jaundice. A binary logistic regression analysis showed good knowledge about jaundice was associated with a high education level (ie, master\u2019s degree or above; OR=5.977, 95% CI: 1.994 to 17.916, p=0.001), prior education on neonatal jaundice (OR=3.617, 95%\u2009CI: 1.637 to 7.993, p=0.001) and male babies (OR=1.714, 95%\u2009CI: 1.122 to 2.617, p=0.013). A positive attitude toward jaundice was associated with being cared for by a \u2018yuesao\u2019 (maternity matron specialised in caring for mothers and newborns) (OR=1.969, 95%\u2009CI: 1.264 to 3.066, p=0.003) and good knowledge about jaundice (OR=1.804, 95%\u2009CI: 1.194 to 2.726, p=0.005). Finally, good practices related to neonatal jaundice were associated with prior education on neonatal jaundice (OR=2.260, 95%\u2009CI: 1.105 to 4.625, p=0.026) and good knowledge about jaundice (OR=3.112, 95%\u2009CI: 2.040 to 4.749, p<jats:italic>&lt;<\/jats:italic>0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Many mothers have poor knowledge about jaundice, especially regarding causes, danger signs and breast milk jaundice. Maternal information-seeking behaviour about neonatal jaundice needs to be improved. Medical staff should incorporate information about the causes\/danger signs of jaundice and breast milk jaundice in maternal health education. It is also necessary to strengthen health education for mothers, especially those with low education and no yuesao, and provide reliable websites where mothers can obtain information about neonatal jaundice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057981","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T11:20:45Z","timestamp":1661340045000},"page":"e057981","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Maternal knowledge, attitudes and practices related to neonatal jaundice and associated factors in Shenzhen, China: a facility-based cross-sectional study"],"prefix":"10.1136","volume":"12","author":[{"given":"Ying","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China"},{"name":"School of Nursing, Southern Medical University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zonglian","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Shen zhen shi bao an qu fu you bao jian yuan, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2354-5199","authenticated-orcid":false,"given":"Wenzhi","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China"},{"name":"School of Nursing, Southern Medical University, Guangzhou, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"2025101813142671000_12.8.e057981.1","unstructured":"Wang WP . Poeple\u2019s Medical Publishing House. Pediatrics 2018."},{"key":"2025101813142671000_12.8.e057981.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.297"},{"key":"2025101813142671000_12.8.e057981.3","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/s41390-019-0608-0","article-title":"Review of bilirubin neurotoxicity I: molecular biology and neuropathology of disease","volume":"87","author":"Riordan","year":"2020","journal-title":"Pediatr Res"},{"key":"2025101813142671000_12.8.e057981.4","first-page":"7","article-title":"Bilirubin induced encephalopathy","volume":"14","author":"Karimzadeh","year":"2020","journal-title":"Iran J Child Neurol"},{"key":"2025101813142671000_12.8.e057981.5","first-page":"331","article-title":"[Clinical characteristics of bilirubin encephalopathy in Chinese newborn infants-a national multicenter survey]","volume":"50","author":"Shi","year":"2012","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"2025101813142671000_12.8.e057981.6","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1038\/pr.2013.208","article-title":"Neonatal hyperbilirubinemia and rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels","volume":"74 Suppl 1","author":"Bhutani","year":"2013","journal-title":"Pediatr Res"},{"key":"2025101813142671000_12.8.e057981.7","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jpeds.2020.01.050","article-title":"Maternal instruction about jaundice and the incidence of acute bilirubin encephalopathy in Nigeria","volume":"221","author":"Wennberg","year":"2020","journal-title":"J Pediatr"},{"key":"2025101813142671000_12.8.e057981.8","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1038\/s41372-018-0094-y","article-title":"Patterns of acute bilirubin encephalopathy in Nigeria: a multicenter pre-intervention study","volume":"38","author":"Diala","year":"2018","journal-title":"J Perinatol"},{"key":"2025101813142671000_12.8.e057981.9","unstructured":"Addendum to Jaundice in newborn babies under 28 days. 2016. London: National Institute for Health and Care Excellence (UK)."},{"key":"2025101813142671000_12.8.e057981.10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jpeds.2020.02.021","article-title":"Maternal instruction on neonatal jaundice: what can we learn from the stop kernicterus in Nigeria (skin) experience?","volume":"221","author":"Watchko","year":"2020","journal-title":"J Pediatr"},{"key":"2025101813142671000_12.8.e057981.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0251846","article-title":"Knowledge, attitudes and practices regarding neonatal jaundice among caregivers in a tertiary health facility in Ghana","volume":"16","author":"Salia","year":"2021","journal-title":"PLoS One"},{"key":"2025101813142671000_12.8.e057981.12","doi-asserted-by":"crossref","first-page":"267","DOI":"10.4314\/gmj.v53i4.3","article-title":"Neonatal jaundice: awareness, perception and preventive practices in expectant mothers","volume":"53","author":"Amegan-Aho","year":"2019","journal-title":"Ghana Med J"},{"key":"2025101813142671000_12.8.e057981.13","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000004804","article-title":"Perceptions, practices, and traditional beliefs related to neonatal jaundice among Egyptian mothers: a cross-sectional descriptive study","volume":"95","author":"Moawad","year":"2016","journal-title":"Medicine"},{"key":"2025101813142671000_12.8.e057981.14","first-page":"685","article-title":"[Experts consensus on principles for diagnosis and treatment of neonatal jaundice]","volume":"48","year":"2010","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"2025101813142671000_12.8.e057981.15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/3901505","article-title":"Knowledge level and determinants of neonatal jaundice: a cross-sectional study in the Effutu Municipality of Ghana","volume":"2018","author":"Adoba","year":"2018","journal-title":"Int J Pediatr"},{"key":"2025101813142671000_12.8.e057981.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-044390","article-title":"Knowledge on neonatal jaundice and its associated factors among mothers in northern Ethiopia: a facility-based cross-sectional study","volume":"11","author":"Demis","year":"2021","journal-title":"BMJ Open"},{"key":"2025101813142671000_12.8.e057981.17","first-page":"49","article-title":"[Content validity index in scale development]","volume":"37","author":"Shi","year":"2012","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban"},{"key":"2025101813142671000_12.8.e057981.18","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1037\/met0000144","article-title":"Thanks coefficient alpha, we'll take it from here","volume":"23","author":"McNeish","year":"2018","journal-title":"Psychol Methods"},{"key":"2025101813142671000_12.8.e057981.19","unstructured":"Li Z . Poeple\u2019s Medical Publishing House. In: Nursing research methods, 2018."},{"key":"2025101813142671000_12.8.e057981.20","doi-asserted-by":"publisher","DOI":"10.1007\/BF02310555"},{"key":"2025101813142671000_12.8.e057981.21","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.7.3.309"},{"key":"2025101813142671000_12.8.e057981.22","doi-asserted-by":"crossref","first-page":"e377","DOI":"10.1097\/SPV.0000000000000941","article-title":"Obstetric nurses' knowledge, attitudes, and professional support related to actual care practices about urinary incontinence","volume":"27","author":"Li","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"2025101813142671000_12.8.e057981.23","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3126\/jbpkihs.v2i1.24965","article-title":"Knowledge about neonatal jaundice among Nepalese mothers","volume":"2","author":"Shrestha","year":"2019","journal-title":"Jnl. BP Koirala Inst. Health Sci."},{"key":"2025101813142671000_12.8.e057981.24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-034079","article-title":"Prevalence of and mothers' knowledge, attitude and practice towards glucose-6-phosphate dehydrogenase deficiency among neonates with jaundice: a cross-sectional study","volume":"10","author":"Kasemy","year":"2020","journal-title":"BMJ Open"},{"key":"2025101813142671000_12.8.e057981.25","doi-asserted-by":"crossref","DOI":"10.5958\/0976-5506.2018.00736.2","article-title":"Assessment of Mothers ' Knowledge and Beliefs toward Care of Neonatal Jaundice in Pediatric Teaching Hospital in Holy Karbala City","volume":"9","author":"Hussein","year":"2018","journal-title":"Indian J Public Health"},{"key":"2025101813142671000_12.8.e057981.26","doi-asserted-by":"crossref","first-page":"210","DOI":"10.2174\/1573396313666170828112038","article-title":"Maternal Empowerment - An Underutilized Strategy to Prevent Kernicterus?","volume":"13","author":"Wennberg","year":"2017","journal-title":"Curr Pediatr Rev"},{"key":"2025101813142671000_12.8.e057981.27","unstructured":"Bratton S , Cantu RM , Stern M . Breast Milk Jaundice(Nursing) 2022."},{"key":"2025101813142671000_12.8.e057981.28","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.184416"},{"key":"2025101813142671000_12.8.e057981.29","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1159\/000516808","article-title":"Molecular characterization of glucose-6-phosphate dehydrogenase deficiency in the Shenzhen population","volume":"85","author":"Gao","year":"2020","journal-title":"Hum Hered"},{"key":"2025101813142671000_12.8.e057981.30","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1002\/humu.23911","article-title":"Chinese newborn screening for the incidence of G6PD deficiency and variant of G6PD gene from 2013 to 2017","volume":"41","author":"Liu","year":"2020","journal-title":"Hum Mutat"},{"key":"2025101813142671000_12.8.e057981.31","first-page":"280","article-title":"Guidelines for clinical application of Chinese patentmedicine in the treatment of neonatal jaundice (2020)","volume":"41","year":"2021","journal-title":"Chin J Integr Tradit Chin West Med"},{"key":"2025101813142671000_12.8.e057981.32","first-page":"5","article-title":"Guidelines for clinical diagnosis and treatment ofPediatrics in traditional Chinese medicine \u00b7 neonatal jaundice (revised)","volume":"14","author":"Minyong","year":"2018","journal-title":"Pediatrics Journal of Traditional Chinese Medicine"},{"key":"2025101813142671000_12.8.e057981.33","doi-asserted-by":"crossref","first-page":"S98","DOI":"10.1038\/sj.jp.7210643","article-title":"Neonatal jaundice--traditional Chinese medicine approach","volume":"21 Suppl 1","author":"Fok","year":"2001","journal-title":"J Perinatol"},{"key":"2025101813142671000_12.8.e057981.34","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-80"},{"key":"2025101813142671000_12.8.e057981.35","doi-asserted-by":"crossref","DOI":"10.2196\/19985","article-title":"Online health information seeking by parents for their children: systematic review and agenda for further research","volume":"22","author":"Kubb","year":"2020","journal-title":"J Med Internet Res"},{"key":"2025101813142671000_12.8.e057981.36","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12906-019-2805-0","article-title":"Parents' experiences of information-seeking and decision-making regarding complementary medicine for children with autism spectrum disorder: a qualitative study","volume":"20","author":"Smith","year":"2020","journal-title":"BMC Complement Med Ther"},{"key":"2025101813142671000_12.8.e057981.37","doi-asserted-by":"crossref","first-page":"447","DOI":"10.2147\/JMDH.S298034","article-title":"Rate and predictors of neonatal jaundice in Northwest Ethiopia: prospective cohort study","volume":"14","author":"Birhanu","year":"2021","journal-title":"J Multidiscip Healthc"},{"key":"2025101813142671000_12.8.e057981.38","first-page":"42","article-title":"The impact of yuesao on the health of mothers and infants","volume":"26","author":"Li","year":"2010","journal-title":"Chinese JounalOf Practical Actical Nursing"},{"key":"2025101813142671000_12.8.e057981.39","first-page":"87","article-title":"Impact of babysitter\u2019s care on health status of infants: a survey study","volume":"18","author":"Yang","year":"2011","journal-title":"Journal of Nursing Science"},{"key":"2025101813142671000_12.8.e057981.40","first-page":"11","article-title":"Practical strategies and policy implications of postpartum Doulas' intervention on postpartum depression","volume":"34","author":"Xing","year":"2021","journal-title":"Medicine and Society"},{"key":"2025101813142671000_12.8.e057981.41","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-021-03203-4","article-title":"Who is the main caregiver of the mother during the doing-the-month: is there an association with postpartum depression?","volume":"21","author":"Peng","year":"2021","journal-title":"BMC Psychiatry"},{"key":"2025101813142671000_12.8.e057981.42","doi-asserted-by":"crossref","DOI":"10.1111\/mcn.13251","article-title":"Factors influencing breastfeeding practices in China: a meta-aggregation of qualitative studies","volume":"17","author":"Wu","year":"2021","journal-title":"Matern Child Nutr"},{"key":"2025101813142671000_12.8.e057981.43","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-192"},{"key":"2025101813142671000_12.8.e057981.44","doi-asserted-by":"crossref","first-page":"8","DOI":"10.26719\/1995.1.1.8","article-title":"Knowledge, attitude and practice the three pillars of excellence and wisdom: a place in the medical profession","volume":"1","author":"Badran","year":"1995","journal-title":"East Mediterr Health J"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-057981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:14:39Z","timestamp":1760818479000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-057981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8]]},"references-count":44,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,24]]},"published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1136\/bmjopen-2021-057981"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-057981","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8]]}}}