性别是否会影响低体重儿的新生儿高胆红素血症？

Does gender affect neonatal hyperbilirubinemia in low-birth-weight infants?

作者信息

Tioseco Jennifer A, Aly Hany, Milner Josh, Patel Kantilal, El-Mohandes Ayman A E

机构信息

Department of Neonatology, The Children's National Medical Center, Washington, DC, USA.

出版信息

Pediatr Crit Care Med. 2005 Mar;6(2):171-4. doi: 10.1097/01.PCC.0000154961.37833.79.

DOI:10.1097/01.PCC.0000154961.37833.79

PMID:15730604

Abstract

BACKGROUND

Neonatal mortality and morbidity are gender-biased in low-birth-weight (LBW) infants. The male disadvantage theory has been suggested to be responsible for these maturational differences.

OBJECTIVE

To examine the impact of gender on neonatal hyperbilirubinemia.

DESIGN/METHODS: A retrospective observational study. Data on all LBW infants admitted to George Washington University neonatal intensive care unit and surviving for >48 hrs from January 1992 to March 2003 were analyzed. Males and females were compared for gestational age, birth weight, race, Apgar scores at 1 and 5 mins, peak bilirubin levels, sepsis, and intraventricular hemorrhage (IVH). Significant differences were entered in a regression model to detect the influence of gender on bilirubin (Bili). Analysis was repeated after stratification of infants into: group A, <1000 g; group B, 1000-1499 g; and group C, 1500-2499 g.

RESULTS

A total of 840 infants were included in this study. When comparing males (n = 407) with females (n = 433), significant differences were detected in birth weight (1,539 +/- 541 vs. 1,428 +/- 549 g; p = .003), IVH (14.2% vs. 9%; p = .025), and Bili (10.1 +/- 3.0 vs. 9.2 +/- 2.8 mg%; p < .001). No differences were detected in gestational age, sepsis, or Apgar 1 and 5. Difference in Bili for the entire group remained significant in the regression model (regression coefficient [RC] = 0.79 +/- 0.22; p < .001). In subgroup analyses: group A Bili (8.4 +/- 2.3 vs. 8.0 +/- 2.0; p = .14) and group B Bili (9.0 +/- 2.1 vs. 9.2 +/- 2.2; p = .51) did not differ in bivariate or multivariate analyses. In group C, Bili was (11.3 +/- 3.1 vs. 10.1 +/- 3.3; p < .001) and remained the only significant difference in the regression model (RC = 1.19 +/- 0.37; p = .001).

CONCLUSIONS

Bili in LBW infants is significantly higher in males when compared with females. After stratification to birth weight subgroups, significance is retained in the 1500- to 2499-g group after logistic regression analysis. Bili levels in infants <1500 g are influenced more significantly by factors other than gender, such as sepsis and IVH.

摘要

背景

低出生体重（LBW）婴儿的新生儿死亡率和发病率存在性别差异。男性劣势理论被认为是造成这些成熟差异的原因。

目的

研究性别对新生儿高胆红素血症的影响。

设计/方法：一项回顾性观察研究。分析了1992年1月至2003年3月入住乔治华盛顿大学新生儿重症监护病房且存活超过48小时的所有低出生体重婴儿的数据。比较了男性和女性在胎龄、出生体重、种族、1分钟和5分钟时的阿氏评分、胆红素峰值水平、败血症和脑室内出血（IVH）情况。将显著差异纳入回归模型以检测性别对胆红素（Bili）的影响。在将婴儿分层为：A组，<1000克；B组，1000 - 1499克；C组，1500 - 2499克后重复分析。

结果

本研究共纳入840名婴儿。比较男性（n = 407）和女性（n = 433）时，在出生体重（1539±541 vs. 1428±549克；p = 0.003）、脑室内出血（14.2% vs. 9%；p = 0.025）和胆红素（10.1±3.0 vs. 9.2±2.8毫克%；p < 0.001）方面检测到显著差异。在胎龄、败血症或1分钟和5分钟时的阿氏评分方面未检测到差异。回归模型中整个组的胆红素差异仍然显著（回归系数[RC] = 0.79±0.22；p < 0.001）。在亚组分析中：A组胆红素（8.4±2.3 vs. 8.0±2.0；p = 0.14）和B组胆红素（9.0±2.1 vs. 9.2±2.2；p = 该文档没有给出具体结果，请补充完整）在双变量或多变量分析中无差异。在C组中，胆红素为（11.3±3.1 vs. 10.1±3.3；p < 0.001），并且在回归模型中仍然是唯一的显著差异（RC = 1.19±0.37；p = 0.001）。