Knudsen A
Department of Gynecology and Obstetrics, County Hospital, Hjørring, Denmark.
Acta Paediatr Scand. 1989 Mar;78(2):217-21. doi: 10.1111/j.1651-2227.1989.tb11059.x.
Umbilical cord serum bilirubin concentration as a predictor of subsequent jaundice was studied in 291 newborns. It was possible to define subgroups of infants with significantly higher or lower risks of developing jaundice. If cord bilirubin was below 20 mumol/l, 2.9% became jaundiced as opposed to 85% if cord bilirubin was above 40 mumol/l. Furthermore, 57% of jaundiced infants with cord bilirubin above 40 mumol/l required phototherapy, but only 9% if cord bilirubin was 40 mumol/l or lower (p less than 0.003). Knowledge of infants at risk of developing jaundice allows simple bilirubin reducing methods to be implemented before jaundice is present and could influence a decision regarding early discharge from hospital. Since the ability of plasma to bind bilirubin in cord blood from jaundiced and non-jaundiced infants showed no significant differences, the increased cord bilirubin among infants who later became jaundiced is presumably caused by increased fetal bilirubin production or decreased removal of bilirubin from the fetal circulation.
对291名新生儿进行了研究，以脐带血清胆红素浓度作为后续黄疸的预测指标。可以确定发生黄疸风险显著较高或较低的婴儿亚组。如果脐带胆红素低于20μmol/L，2.9%的婴儿会出现黄疸；而如果脐带胆红素高于40μmol/L，这一比例则为85%。此外，脐带胆红素高于40μmol/L的黄疸婴儿中有57%需要光疗，但如果脐带胆红素为40μmol/L或更低，这一比例仅为9%（p<0.003）。了解有发生黄疸风险的婴儿，可在黄疸出现前实施简单的降低胆红素方法，并可能影响关于早期出院的决定。由于黄疸婴儿和非黄疸婴儿脐带血中血浆结合胆红素的能力无显著差异，后来出现黄疸婴儿的脐带胆红素升高可能是由于胎儿胆红素生成增加或胎儿循环中胆红素清除减少所致。
