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足月高胆红素血症婴儿血清胆红素峰值与神经发育结局的关系。

Association between peak serum bilirubin and neurodevelopmental outcomes in term babies with hyperbilirubinemia.

机构信息

Department of Pediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry 605 006, India.

出版信息

Indian J Pediatr. 2012 Feb;79(2):202-6. doi: 10.1007/s12098-011-0501-2. Epub 2011 Jun 25.

Abstract

OBJECTIVE

To find the association between neonatal Peak serum bilirubin (PSB) levels and the neurodevelopmental outcomes at 6 months in term infants with neonatal hyperbilirubinemia.

METHODS

Term neonates who developed jaundice with atleast one PSB value of above 15 mg/dl within first wk of life were included. Babies with any condition affecting the neurodevelopment, like prematurity, convulsions or asphyxia were excluded from the study. This prospective cohort study included 66 term babies out of the 6548 newborns delivered during the study period.

RESULTS

The incidence of abnormal developmental quotient gradually increased with increase in the level of PSB. Based on univariate analysis, a PSB ≥ 22 mg/dl (the cut off obtained based on Receiver operating characteristic curve), Rh incompatibility and occurrence of jaundice within 2 days of life were found to be significant risk factors for abnormal developmental quotient. These three risk factors were also independently associated with abnormal development by multivariate logistic regression analysis.

CONCLUSIONS

PSB level of ≥ 22 mg/dl, Rh incompatibility and occurrence of jaundice within 2 days of life are independent predictors of abnormal development in babies with neonatal jaundice.

摘要

目的

探讨足月新生儿高胆红素血症中,新生儿血清胆红素(PSB)峰值与 6 个月神经发育结局的关系。

方法

纳入生后第 1 周内至少有 1 次 PSB 值>15mg/dl 的出现黄疸的足月新生儿。排除有影响神经发育的任何情况的患儿,如早产、抽搐或窒息。该前瞻性队列研究纳入了 6548 例新生儿中 66 例足月患儿。

结果

根据单变量分析,PSB≥22mg/dl(根据受试者工作特征曲线得出的截断值)、Rh 不合及生后 2 天内出现黄疸与发育商异常的发生逐渐相关。多变量逻辑回归分析显示,这 3 个危险因素与发育异常也独立相关。

结论

PSB 水平≥22mg/dl、Rh 不合及生后 2 天内出现黄疸是新生儿黄疸患儿发育异常的独立预测因素。

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