Neonatal Hyperbilirubinemia Perinatal Risk Factors

Objective To study on the effect of perinatal high risk factors on neonatal hyperbilirubinemia (NHB)in order to provide a reasonable clinical basic for prevention and treatment.Methods Serum bilirubin levels of 2512 neonates in beihai people's hospital from January 2005 to December 2007 were continuously monitored. Several perinatal factors possibly related to neonatal jaundice were recorded, such as sex, parity, gestational age, complications,materal age, pregnancy complications, fetal distress,labor mode, meconium stained amniotic fluid, premature rupture of fetal membrane, situation of the fetus umbilical cord twine, Apgar score,feeding time,excreting meconium time, breast-feeding and maternal conditions, application of antibiotic,blood glucose, hematokrit, birth weight and changes. The affects of the perinatal factors on neonatal hyperbilirubinemia were analyzed by the methods of single-factor analysis and Logistic regression analysis, respectively.Results Analysis showed that cesarean section delivery, no enough breast feeding, hypoglycemia, loss of weight greatly in first three days, perinatal asphyxia, fetal distress, senior age of mother, infection, the use of oxytocin before delivery were influencing factors of neonatal hyperbilirubinemia.Our results suggest that the incidence of neonatal hyperbilirubinemia was 34.6%, and mobidity in cesarean section group was higher than vaginal delivery group, 39.3% vs. 29.0% (P<0.05). In cases of NHB, the breastfeeding ratio of cesarean section group was low,but the after birth weight loss ratio was high, while the incidence of asphyxia,RDS,TTN was high, which significant diffenence was also observed (P<0.05). In caesarean group, the morbidity of neonatal hyperbilirubinemia with maternal pregnant complications was 42.4%, which was higher than the group of without maternal pregnant complications 38.3%, but significant difference was not observed (P>0.05).Conclusion As perinatal risk factors for NHB,cesarean section delivery,decline in body weight and no enough breast-feeding should be attentioned and provided early intervention for them.