临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (3): 214-217.

• 围产新生儿疾病专栏 • 上一篇    下一篇

晚期早产儿高胆红素血症危险因素分析

杨树杰, 易海英, 汪珍珍, 黄杰, 何源, 魏贤, 王艳华   

  1. 孝感市中心医院新生儿科(湖北孝感 432000)
  • 收稿日期:2013-08-26 出版日期:2014-03-15 发布日期:2014-03-15

Analysis of risk factors of late preterm infants with hyperbilirubinemia

 YANG Shujie, YI Haiying, WANG Zhenzhen, HUANG Jie, HE Yuan, WEI Xian, WANG Yanhua   

  • Received:2013-08-26 Online:2014-03-15 Published:2014-03-15

摘要:

入院时日龄<3 d、出生窒息、小于胎龄儿、头颅血肿或明显产伤淤血、低白蛋白血症、红细胞增多症、感染、溶血病、喂养不耐受、胎粪排泄延迟10个变量;与母亲相关的因素包括:来自农村、妊娠高血压综合征(妊高症)及胎膜早破3个变量。以上变量在高胆红素血症和非高胆红素血症晚期早产儿中的差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,出生窒息、胎粪排泄延迟、低白蛋白血症和母亲妊高症为晚期早产儿高胆红素血症的危险因素(OR=2.35~4.05);母亲妊高症和新生儿溶血病是晚期早产儿发生重度高胆红素血症的危险因素(OR=5.74、73.64)。结论 出生窒息、胎粪排泄延迟、低白蛋白血症、溶血病及母亲妊高症是晚期早产儿高胆红素血症发生的高危因素。加强妊高症和新生儿溶血病诊治,可减少晚期早产儿重度高胆红素血症的发生。

Abstract:  Objective To explore the risk factors of hyperbilirubinemia in late preterm infants. Methods Clinical data of 211 cases of late preterm infants with hyperbilirubinemia and 246 cases of late preterm infants without hyperbilirubinemia were retrospectively analyzed between 2011 and 2012. The risk factors of hyperbilirubinemia were filtered. Results Twenty-seven cases of late premature infants with hyperbilirubinemia were severe. Hospital stay less than 3 days, birth asphyxia history, small for gestatio-nal age, head hematoma, delivery injury, hypoalbuminemia, polycythemia, infection, hemolytic disease, feeding intolerance, and fetal excretion delay were associated with hyperbilirubinemia (P<0.05). Rural origin, pregnancy-induced hypertension syndrome and premature rupture of membrane were also associated with hyperbilirubinemia (P<0.05). Multivariate logistic regression analysis showed the history of birth asphyxia , fetal excretion delay, hypoalbuminemia, pregnancy-induced hypertension syndrome were risk factors of hyperbilirubinemia in late preterm infants (OR=2.35-4.05). Pregnancy-induced hypertension syndrome and hemolytic disease were risk factors of severe hyperbilirubinemia in late preterm infants (OR=5.74, 73.64). Conclusions Neonatal asphyxia, fetal excretion delay, hypoalbuminemia and pregnancy-induced hypertension syndrome are risk factors of hyperbilirubinemia in late preterm infants. Strengthening the management of pregnancy-induced hypertension syndrome and the treatment of newborn hemolytic disease can reduce the occurrence of severe hyperbilirubinemia in late preterm infants.#br#Key words: hyperbilirubinemia; preterm; risk factor#br#