Wang Zeng-Qin, Gao Yan, Dong Xiao-Yue, Wang Huai-Yan, Lu Hong-Yan, Chen Xiao-Qing, Xue Mei, Zhang Jia, Wu Ming-Fu, Wan Jun, Wu Xin-Ping, Pan Zhao-Jun, Deng Xiao-Yi, Han Shu-Ping, Qiao Yu, Yang Li, Yu Zhang-Bin
Department of Pediatrics, Women's Hospital of Nanjing Medical University, Nanjing 210004, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Jun 15;24(6):669-674. doi: 10.7499/j.issn.1008-8830.2112113.
To investigate the preadmission follow-up condition of neonates hospitalized due to severe hyperbilirubinemia after discharge from the department of obstetrics and the influencing factors for follow-up compliance.
A multicenter retrospective case-control study was performed for the cases from the multicenter clinical database of 12 units in the Quality Improvement Clinical Research Cooperative Group of Neonatal Severe Hyperbilirubinemia in Jiangsu Province of China from January 2019 to April 2021. According to whether the follow-up of neonatal jaundice was conducted on time after discharge from the department of obstetrics, the neonates were divided into two groups: good follow-up compliance and poor follow-up compliance. The multivariate logistic regression model was used to identify the influencing factors for follow-up compliance of the neonates before admission.
A total of 545 neonates with severe hyperbilirubinemia were included in the study, with 156 neonates (28.6%) in the good follow-up compliance group and 389 (71.4%) in the poor follow-up compliance group. The multivariate logistic regression analysis showed that low gestational age at birth, ≥10% reduction in body weight on admission compared with birth weight, history of phototherapy of siblings, history of exchange transfusion of siblings, Rh(-) blood type of the mother, a higher educational level of the mother, the use of WeChat official account by medical staff to remind of follow-up before discharge from the department of obstetrics, and the method of telephone notification to remind of follow-up after discharge were associated with the increase in follow-up compliance (<0.05).
Poor follow-up compliance is observed for the neonates with severe hyperbilirubinemia after discharge from the department of obstetrics, which suggests that it is necessary to further strengthen the education of jaundice to parents before discharge and improve the awareness of jaundice follow-up. It is recommended to remind parents to follow up on time by phone or WeChat official account.
探讨因重度高胆红素血症住院的新生儿出院后在产科的入院前随访情况及随访依从性的影响因素。
对中国江苏省新生儿重度高胆红素血症质量改进临床研究协作组12个单位的多中心临床数据库中2019年1月至2021年4月的病例进行多中心回顾性病例对照研究。根据新生儿出院后黄疸随访是否按时进行，将新生儿分为两组：随访依从性好和随访依从性差。采用多因素logistic回归模型确定入院前新生儿随访依从性的影响因素。
本研究共纳入545例重度高胆红素血症新生儿，随访依从性好的组有156例（28.6%），随访依从性差的组有389例（71.4%）。多因素logistic回归分析显示，出生孕周小、入院时体重较出生体重下降≥10%、同胞有光疗史、同胞有换血史、母亲Rh（-）血型、母亲文化程度较高、产科出院前医护人员使用微信公众号提醒随访、出院后电话通知提醒随访的方式与随访依从性增加有关（<0.05）。
因重度高胆红素血症住院的新生儿出院后随访依从性较差，提示有必要在出院前进一步加强对家长的黄疸知识教育，提高黄疸随访意识。建议通过电话或微信公众号提醒家长按时随访。
