足月新生儿不明原因高胆红素血症相关因素分析

摘要

目的 探讨导致足月新生儿不明原因高胆红素血症的可能危险因素.方法 选择2007年7月～2009年10月经临床确诊的112例足月原因不明的高胆红素血症新生儿(病例组),以及同期137例正常足月新生儿(对照组),比较两组新生儿孕周、出生身高、性别、出生体重、出生体温、喂养情况、排便情况、孕母年龄、家族黄疸发病史、是否多胎、妊娠合并症高血压、糖尿病及胎盘钙化等情况,分析上述影响因素与新生儿高胆红素血症的相关性.结果 两组新生儿孕周、出生体温、出生体重、出生身高、孕母年龄、胎盘钙化、多胎史方面差异均无统计学意义(P ＞ 0.05);病例组新生儿开奶时间及开始排便时间均较对照组晚,生后2 d喂养总量及生后2 d排便总量均较对照组少,差异均有统计学意义(P ＜ 0.01、P ＜ 0.05);两组新生儿性别、分娩方式、母妊娠高血压、妊娠糖尿病、家族黄疸发病史差异均有统计学意义(P ＜ 0.05).结论 开奶时间晚及排便时间延迟、生后2 d喂养量不足及生后2 d排便量少是足月新生儿不明原因高胆红素血症的危险因素;剖宫产、孕母有妊娠高血压、妊娠糖尿病及家族中有黄疸发病史是足月新生儿不明原因高胆红素血症的高危因素.%Objective To explore the possible risk factors for unexplained hyperbilirubinemia in full -term newborns. Methods A total of 112 full-term newborns with unexplained hyperbilirubinemia (case group) confirm in clinic and 137 normal full-term newborns (control group) were selected from July 2007 to October 2009, the gestational weeks, birth height, gender, birth weight, birth body temperature, feeding, defecation, mothers' age, family jaundice history, superfoetation, complicated with hypertension, diabetes and placental calcification of two groups were compared, and then the correlations between the above influential factors and newborn hyperbilirubinemia were analyzed. Results No statistical difference in newborn gestational weeks, birth temperature, birth weight, birth height, mothers' age, placental calcification and super foetation were observed between the two groups (P > 0.05); the breastfeed time and defecation time of newborns in case group were later than those of control group, the total feeding volume and defecation volume in the first 2 days after birth were smaller than those of control group (P < 0.01, P < 0.05); statistical differences in gender, delivery mode, gestational hypertension, gestational diabetes and family jaundice history were observed between the two groups (P < 0.05). Conclusion Later breastfeed and delayed defecation time, insufficient feeding volume and less defecation volume in the first 2 days after birth are risk factors; and uterine-incision delivery, mothers' gestational diabetes and family jaundice history are the high risk factors leading to unexplained hyperbilirubinemia in full-term newborns.