蒙古族和汉族足月新生儿高胆红素血症发病情况及相关影响因素

Prevalence of hyperbilirubinemia among Mongolian and Han full-term neonates and the related influencing factors

目的探讨蒙古族和汉族新生儿高胆红素血症的发病情况,分析相关影响因素,为临床诊治提供依据。方法选取2014年6月-2016年5月在该院产科分娩的蒙古族(104例)和汉族(102例)足月新生儿及母亲为研究对象,记录胎龄、出生体重、性别、分娩方式、喂养方式、初乳分泌时间、胎便排出时间、胎膜早破、头颅血肿、孕期户外运动情况等。采用日本美能JM经皮胆红素测定仪监测其出生后1周内经皮胆红素值(TCB),2次/d,每天监测胆红素水平并计算峰值,比较两民族新生儿高胆红素血症发病率和影响因素,将有关高危因素进行Logistic回归分析。结果在206例新生儿中,诊断为高胆红素血症患儿88例,汉族新生儿高胆红素血症发病率高于蒙古族新生儿(χ~2=47.353,P<0.001),且峰值汉族新生儿较高;初乳分泌时间>24 h(OR=2.963)、汉族(OR=11.122)、剖宫产(OR=2.886)、人工或混合喂养(OR=4.245)、胎便排出时间>24 h(OR=4.212)、孕期活动量<6 h(OR=12.495)为发生新生儿高胆红素血症的独立危险因素。结论蒙古族足月新生儿高胆红素血症的发病率低于汉族新生儿,且黄疸程度较轻;初乳分泌时间>24 h、汉族、剖宫产、人工或混合喂养、胎便排出时间>24 h、孕期活动量<6 h为发生新生儿高胆红素血症的独立危险因素,这可能与两民族不同的生活方式、结构、环境等有关。

Objective To explore the prevalence of hyperbilirubinemia among Mongolian and Han full-term neonates,analyze the related influencing factors,and provide a basis for clinical diagnosis and treatment. Methods A total of 104 Mongolian full-term neonates and 102 Han full-term neonates and their mothers were selected from the hospital from June 2014 to May 2016. Gestational age,birth weight,gender,delivery modes,feeding patterns,colostrum time,meconium discharge time,premature rupture of membranes,cranial hematoma,outdoor exercise during pregnancy were recorded. Percutaneous bilirubin determinator was used to monitor percutaneous bilirubin levels within one week after birth,twice a day. Bilirubin levels were monitored every day,then the peak level was calculated. The incidence rate and influencing factors of hyperbilirubinemia were compared between Mongolian full-term neonates and Han full-term neonates. The related high-risk factors were analyzed by logistic regression analysis. Results Among 206 neonates,88 neonates were diagnosed as hyperbilirubinemia. The incidence rate of hyperbilirubinemia among Han neonates was statistically significantly higher than that among Mongolian neonates（ χ^2= 47. 353,P〈0. 001）,and the peak level of bilirubin among Han neonates was higher than that among Mongolian neonates. The independent risk factors of neonatal hyperbilirubinemia included colostrum secretion time 〉24 hours（ OR = 2. 963）,Han nationality（ OR =11. 122）,cesarean section（ OR = 2. 886）,artificial or mixed feeding（ OR = 4. 245）,meconium discharge time 〉24 hours（ OR = 4. 212）,activity time during pregnancy〈6 hours（ OR = 12. 495）. Conclusion The incidence rate of neonatal hyperbilirubinemia among Mongolian full-term neonates is lower than that among Han full-term neonates,and the degree of jaundice is milder; colostrum secretion time 〉24 hours,Han nationality,cesarean section,artificial or mixed feeding,meconium discharge time 24 hours,and activity time during pregnancy6 hours are independent risk factors of neonatal hyperbilirubinemia,which may be related to different life styles,structures and environments of the two nationalities.