Ebbesen F, Andersson C, Verder H, Grytter C, Pedersen-Bjergaard L, Petersen J R, Schaarup J
Department of Paediatrics, Aalborg University Hospital, Denmark.
Acta Paediatr. 2005 Jan;94(1):59-64. doi: 10.1111/j.1651-2227.2005.tb01789.x.
To determine the incidence amongst infants born at term or near-term of extreme hyperbilirubinaemia, i.e., with a serum concentration of unconjugated bilirubin exceeding the limit above which an exchange transfusion was indicated according to the authorized guidelines.
The investigation period covered 2 y, 1 January 2000 to 31 December 2001, and included all infants born alive at term or near-term in Denmark. All infants with extreme hyperbilirubinaemia admitted to paediatric departments were recorded.
Thirty-two infants developed extreme hyperbilirubinaemia, i.e., an incidence of 25 per 100 000. The maximum total serum bilirubin concentration (TSB) was 492 (385-689) micromol/I (median (range)). The median value of the exchange transfusion limits was 450 micromol/l. Twelve infants had signs and symptoms of central nervous system involvement; 11 had acute bilirubin encephalopathy phase-1 symptoms; and one had phase-2 symptoms. Nineteen infants developed extreme hyperbilirubinaemia during primary admission to the maternity ward or neonatal department; the others after having been discharged. There was no difference in maximum TSB between those infants not discharged from hospital and those infants admitted to hospital from home. Maximum TSB appeared latest amongst those infants admitted from home (p < 0.01), and these more often had signs and symptoms of central nervous system involvement (p < 0.05). Ten infants were of non-Caucasian extraction. Less than half of all Danish mothers receive both verbal and written information after birth on jaundice in the infant.
Twenty-five per 100 000 infants born at term or near-term developed extreme hyperbilirubinaemia, the majority of them whilst in hospital. Infants admitted from home more often had signs and symptoms of central system involvement.
确定足月儿或近足月儿中极重度高胆红素血症的发生率，即血清未结合胆红素浓度超过根据权威指南需进行换血治疗的上限。
调查期为2年，从2000年1月1日至2001年12月31日，纳入丹麦所有足月或近足月出生的活产婴儿。记录所有入住儿科病房的极重度高胆红素血症婴儿。
32例婴儿发生极重度高胆红素血症，发生率为每100 000例中有25例。血清总胆红素（TSB）最高浓度为492（385 - 689）微摩尔/升（中位数（范围））。换血治疗上限的中位数为450微摩尔/升。12例婴儿有中枢神经系统受累的体征和症状；11例有急性胆红素脑病1期症状；1例有2期症状。19例婴儿在初次入住产科病房或新生儿科期间发生极重度高胆红素血症；其他婴儿在出院后发生。未出院婴儿与从家中入院婴儿的最高TSB无差异。从家中入院的婴儿最高TSB出现最晚（p < 0.01），且这些婴儿更常出现中枢神经系统受累的体征和症状（p < 0.05）。10例婴儿为非白种人血统。丹麦不到一半的母亲在婴儿出生后接受了关于黄疸的口头和书面信息。
每100 000例足月或近足月出生的婴儿中有25例发生极重度高胆红素血症，其中大多数发生在住院期间。从家中入院的婴儿更常出现中枢系统受累的体征和症状。
