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）。