Ali Bulbul, MD, Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Children Hospital, Istanbul, Turkey.
Nihal Cayonu, MD, Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Children Hospital, Istanbul, Turkey.
Pak J Med Sci. 2014 Sep;30(5):1113-8. doi: 10.12669/pjms.305.5080.
To determine clinical features, etiology and risk factors in term and near term newborns with severe hyperbilirubinemia.
During ten years period (2000 - 2009), infants of ≥ 35 gestational weeks who received phototherapy were evaluated retrospectively. The study population was divided into two groups and clinical features, etiology and risk factors were compared. Group 1 defined by those who had bilirubin level ≥25 mg/dl (severe hyperbilirubinemia) and group 2 defined by bilirubin level <25 mg/dl.
During the study period 1335 babies were evaluated. Severe hyperbilirubinemia was found in 137 (10.3%) patients. Total serum bilirubin level was 29.7±4.7 mg/dl in group 1 and 18.9±3.5 mg/dl in group 2. Pathological weight loss, vaginal delivery and supplementary feeding were identified as significant risk factors for development of severe hyperbilirubinemia (p <0.001, p <0.001 and p = 0.04, respectively). The time at recognition of jaundice by family and postnatal age at admission were significantly higher in group 1. The ratios of previous sibling received phototherapy and being the second child or after were found higher in group 1.
Pathological weight loss, vaginal delivery and supplementary feeding were determined as risk factors for development of severe hyperbilirubinemia. The newborns with severe hyperbilirubinemia had late recognition of jaundice and admission to hospital by their families.
确定足月和近足月新生儿重度高胆红素血症的临床特征、病因和危险因素。
在十年期间（2000 年至 2009 年），回顾性评估了接受光疗的≥35 孕周的婴儿。研究人群分为两组，比较了临床特征、病因和危险因素。第 1 组定义为胆红素水平≥25mg/dl（重度高胆红素血症），第 2 组定义为胆红素水平<25mg/dl。
在研究期间，评估了 1335 名婴儿。137 名（10.3%）患儿出现重度高胆红素血症。第 1 组总血清胆红素水平为 29.7±4.7mg/dl，第 2 组为 18.9±3.5mg/dl。病理性体重下降、阴道分娩和补充喂养被确定为重度高胆红素血症发生的显著危险因素（p<0.001、p<0.001 和 p=0.04）。第 1 组家庭发现黄疸的时间和入院时的产后年龄明显较高。第 1 组中，有前一个同胞接受光疗和第二个孩子或以后的比例较高。
病理性体重下降、阴道分娩和补充喂养被确定为重度高胆红素血症发生的危险因素。重度高胆红素血症新生儿的黄疸发现和家庭入院时间较晚。
