正常新生儿黄疸与围产因素的调查

A Survey on Neonatal Jaundice and Perinatal Factors

目的 探讨围产期各种非病理因素对正常新生儿血清胆红素水平的影响。 方法 对80 1例正常新生儿生后 2 4h内开始监测血清胆红素水平 ,并记录围产期可能与新生儿黄疸有关的各种因素。被检测的新生儿按血清胆红素水平分为高胆红素组和随机对照组 ,比较两组间各种围产因素对生后 5 d内血清胆红素的影响。 结果 母乳喂养、妊娠高血压综合征 (简称妊高征 )、出生体重下降和生后红细胞压积增高对正常新生儿早期血清胆红素水平有显著影响 (P<0 .0 0 1)。母亲年龄、分娩方式、第二产程时间、催产素使用时间、出生体重等两组比较差异无显著性。 结论 母乳喂养 ,母亲妊高征、出生体重下降和生后红细胞压积增高 ,是正常新生儿出生后胆红素水平上升时期影响血清胆红素水平的重要潜在因素。

Objective To demonstrate the influence of the perinatal factors on neonatal serum bilirubin level in normal neonatal population. Methods Serum bilirubin level of 801 healthy babies were continuously monitored and the perinatal factors related to neonatal jaundice were recorded. 298 newborn with high serum bilirubin level(>12. 9 mg/dl) were compared to 298 newborn with low serum bilirubin level randomly selected from the remaining 503 subjects. Results High bilirubin level was significantly associated with brease feeding, pregnancy induced hypertension of mothers, loss of birthweight, and high hematocrit( P<0.001 ). There were no significant association of high bilirubin level with maternal age, maternal blood type, oxitocin induction of mothers, the length of the second labor stage, and the route of delivery. Conclusions Breast feeding, pregnancy induced hypertension of the mothers, high hematocrit, and loss of brithweight are important potential factors contributed to serum bilirubin level in early newborn stage.