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母乳喂养婴儿的高胆红素血症风险。

Risk of hyperbilirubinemia in breast-fed infants.

机构信息

Department of Pediatrics, Far Eastern Memorial Hospital, Pan-Chiao, Taipei, Taiwan.

出版信息

J Pediatr. 2011 Oct;159(4):561-5. doi: 10.1016/j.jpeds.2011.03.042. Epub 2011 May 18.

DOI:10.1016/j.jpeds.2011.03.042
PMID:21592495
Abstract

OBJECTIVE

To investigate the risk factors for hyperbilirubinemia in infants who are exclusively breast-fed.

STUDY DESIGN

A prospective study was conducted to investigate the effects of birth body weight, sex, mode of delivery, glucose-6-phosphate dehydrogenase (G6PD) deficiency, variant UDP-glucuronosyltransferase 1A1 (UGT1A1) gene, and hepatic solute carrier organic anion transporter 1B1 (SLCO1B1) gene on hyperbilirubinemia in neonates who were breast-fed. Hyperbilirubinemia was diagnosed when a full term neonate had a bilirubin level ≧15.0 mg/dL (256.5 μM) in serum at 3 days old. The polymerase chain reaction-restriction fragment length polymorphism method was used as a means of detecting the known variant sites in the UGT1A1 and SLCO1B1 gene.

RESULTS

Of 252 infants born at term who were exclusively breast-fed, 59 (23.4%) had hyperbilirubinemia. The significant risk factors were a variant nucleotide 211 in UGT1A1 (2.48; 95% CI, 1.29 to 4.76; P = .006), G6PD deficiency (12.24; 95% CI, 1.08 to 138.62; P < .05), and vaginal delivery (3.55; 95% CI, 1.64 to 7.66; P < .001).

CONCLUSION

Breast-fed neonates who are 211 variants in the UGT1A1, G6PD deficiency, and vaginal delivery are at high-risk for hyperbilirubinemia.

摘要

目的

研究纯母乳喂养婴儿高胆红素血症的危险因素。

研究设计

前瞻性研究调查了出生体重、性别、分娩方式、葡萄糖-6-磷酸脱氢酶(G6PD)缺乏、变异型尿苷二磷酸葡萄糖醛酸转移酶 1A1(UGT1A1)基因和肝脏溶质载体有机阴离子转运蛋白 1B1(SLCO1B1)基因对母乳喂养新生儿高胆红素血症的影响。当足月新生儿在 3 天时血清胆红素水平≧15.0mg/dL(256.5μM)时,诊断为高胆红素血症。聚合酶链反应-限制性片段长度多态性方法用于检测 UGT1A1 和 SLCO1B1 基因中已知的变异位点。

结果

在 252 名足月母乳喂养的婴儿中,有 59 名(23.4%)患有高胆红素血症。显著的危险因素是 UGT1A1 中的变异核苷酸 211(2.48;95%CI,1.29 至 4.76;P=0.006)、G6PD 缺乏(12.24;95%CI,1.08 至 138.62;P<0.05)和阴道分娩(3.55;95%CI,1.64 至 7.66;P<0.001)。

结论

UGT1A1 211 变异、G6PD 缺乏和阴道分娩的母乳喂养新生儿发生高胆红素血症的风险较高。

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