脐血胆红素、白蛋白、网织红细胞计数及有核红细胞预测足月儿随后发生的高胆红素血症：一项前瞻性观察研究

Umbilical Cord Blood Bilirubin, Albumin, Reticulocyte Count, and Nucleated Red Blood Cells to Predict Subsequent Hyperbilirubinemia in Term Neonates: A Prospective Observational Study.

作者信息

Chakrahari Sadgunraju, Patil Mallanagouda, Bijapure Hidaytullah R

机构信息

Pediatrics, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, IND.

Pediatric Medicine, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, IND.

出版信息

Cureus. 2023 Apr 14;15(4):e37598. doi: 10.7759/cureus.37598. eCollection 2023 Apr.

DOI:10.7759/cureus.37598

PMID:37197121

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10183647/

Abstract

INTRODUCTION

Hyperbilirubinaemia is one of the most important causes of re-admission in the early neonatal period. The socioeconomic factors are one of the most common reasons for early discharge in a developing country like India.

OBJECTIVES

This study aims to evaluate and analyze the statistical correlation of umbilical cord blood bilirubin, albumin, nucleated red blood cells (nRBC), and reticulocyte count as early predictors of neonatal hyperbilirubinemia.

METHOD

A prospective observational study was conducted from November 2015 to April 2017 in a tertiary care hospital in North Karnataka, India. Umbilical cord blood was collected at birth for analysis of bilirubin, albumin, reticulocyte count, and nRBC in term neonates. Total serum bilirubin (TSB) levels were estimated using the VITROS BuBc Slide method at 72 hours of life. Data were analyzed using SPSS version 23 (IBM Corp., Armonk, NY).

RESULTS

A total of 200 term neonates were enrolled in the study, out of which 123 completed follow-ups. Of the 66 newborns who had cord bilirubin levels ≥1.75 mg/dl, 23 (34.8%) developed hyperbilirubinemia after 72 hours of life, whereas 10 of the 57 newborns (17.5%) whose cord bilirubin levels <1.75 mg/dl developed hyperbilirubinemia after 72 hours of life. Cord blood albumin of ≥3.75 g/dl was seen in 93 neonates, of which 18 (19.4%) developed hyperbilirubinemia after 72 hours of life and 15 (50%) with <3.75 g/dl developed hyperbilirubinemia after 72 hours of life. Cord reticulocyte count ≥4.95% was seen in 54 neonates; 20 (37.03%) developed hyperbilirubinemia, whereas in 69 neonates with <4.95%, 13 (18.84%) developed hyperbilirubinemia after 72 hours of life. Of the 62 neonates who had cord nRBC ≥3.5%, 28 (45.2%) neonates developed hyperbilirubinemia after 72 hours of life, whereas 5 of the 61 neonates (8.19%) with cord nRBC <3.5% developed hyperbilirubinemia after 72 hours of life.

CONCLUSIONS

Cord blood bilirubin, albumin, reticulocyte counts, and nucleated RBC can be used as predictors of subsequent neonatal hyperbilirubinemia.

摘要

引言

高胆红素血症是新生儿早期再次入院的最重要原因之一。社会经济因素是像印度这样的发展中国家早期出院的最常见原因之一。

目的

本研究旨在评估和分析脐血胆红素、白蛋白、有核红细胞（nRBC）和网织红细胞计数作为新生儿高胆红素血症早期预测指标的统计相关性。

方法

2015年11月至2017年4月在印度北卡纳塔克邦的一家三级护理医院进行了一项前瞻性观察研究。在足月新生儿出生时采集脐血，用于分析胆红素、白蛋白、网织红细胞计数和nRBC。在出生72小时时使用VITROS BuBc Slide方法估算总血清胆红素（TSB）水平。使用SPSS 23版（IBM公司，纽约州阿蒙克）分析数据。

结果

共有200名足月新生儿纳入研究，其中123名完成了随访。在66名脐血胆红素水平≥1.75mg/dl的新生儿中，有23名（34.8%）在出生72小时后发生高胆红素血症，而在57名脐血胆红素水平<1.75mg/dl的新生儿中，有10名（17.5%）在出生72小时后发生高胆红素血症。93名新生儿的脐血白蛋白≥3.75g/dl，其中18名（19.4%）在出生72小时后发生高胆红素血症，15名（50%）白蛋白<3.75g/dl的新生儿在出生72小时后发生高胆红素血症。54名新生儿的脐血网织红细胞计数≥4.95%；20名（占比37.03%）发生高胆红素血症，而在69名网织红细胞计数<4.95%的新生儿中，13名（18.84%）在出生72小时后发生高胆红素血症。在62名脐血nRBC≥3.5%的新生儿中，28名（45.2%）在出生72小时后发生高胆红素血症，而在61名脐血nRBC<3.5%的新生儿中，5名（8.19%）在出生72小时后发生高胆红素血症。