新生儿高胆红素血症的病因及危险因素分析

Analysis on pathogenesis and risk factors of hyperbilirubinemia in neonates

目的探讨新生儿高胆红素血症的病因及临床危险因素。方法对2005年1月—2010年12月的560例高胆红素血症新生儿临床资料,采用多因素Logistic回归分析其临床危险因素。结果 560例高胆红素血症新生儿的病因主要为母乳性黄疸(37.7%)、ABO血型不合溶血(16.4%)、感染相关因素(15.2%)、围产期相关因素(12.1%)、胆汁排泄障碍(6.3%)、红细胞增多症(5.0%)和先天性因素(4.5%)。母乳性黄疸、ABO血型不合溶血、感染相关因素、围生期相关因素、胆汁排泄障碍、红细胞增多症、先天性因素和其他不明原因为危险因素(P<0.05),而与性别无关(P>0.05)。围生期的危险因素有孕母年龄、胎龄、出生体质量、1 min Apgar评分、产式、宫内窘迫、催产素、出血、开奶时间、胎粪排出时间和喂养方式(P<0.05),而性别和胎次则不是危险因素(P>0.05)。结论母乳性黄疸为新生儿高胆红素血症的主要原因,危险因素主要包括母乳性黄疸和ABO血型不合溶血等;围生期危险因素为孕母年龄、胎龄和出生体质量等。

Objective To study the pathogenesis and risk factors of hyperbilirubinemia in neonates. Methods Clinical data of risk factors in 560 neonates with hyperbilirubinemia from January 2005 to December 2010 were analyzed with Logistic regression analysis. Results The main pathogenesis of hyperbilirubinemia in neonates were breast-feeding jaundice（37.7%）,blood type incompatibility of ABO（16.4%）,infection related factors（15.2%）,perinatal period related factors（12.1%）,bile acatharsia（6.3%）,erythrocytosis（5.0%） and congenital factors（4.5%）.Breast-feeding jaundice,blood type incompatibility of ABO,infection related factors,perinatal period related factors,bile acatharsia,erythrocytosis and congenital factors and other unknown factors were risk factors for hyperbilirubinemia（P0.05）.Age of mother,gestation age,birth weight,1min Apgar score,intrauterine distress,pitocin,bleeding,breastfeed time,time of excretion of meconium and feeding patterns were risk factors for hyperbilirubinemia in perinatal period. Conclusion The main pathogenesis of hyperbilirubinemia in neonates were breast-feeding jaundice and the main risk factors for hyperbilirubinemia were breast-feeding jaundice and blood type incompatibility of ABO,while they were ages of mother,gestation age and birth weight in perinatal period.