| Objective:(1)To understand the clinical characteristics of neonatal G6 PD deficiency with hyperbilirubinemia;(2)Analysis of high risk factors for total serum bilirubin peak reach to exchange blood level in neonates with G6 PD deficiency and hyperbilirubinemia.Methods:A retrospective study was conducted to select neonates with G6 PD deficiency of gestational age ≥35 weeks who were admitted to the Department of Pediatrics,Hunan Children’s Hospital from January 1,2013 to December 31,2017.Through single factor analysis and multivariate logistic regression,the influencing factors of TSB peak value reaching exchange blood level in G6 PD deficiency patients with hyperbilirub-inemia were explored,including general data,family history,intrapartum status,diagnosis and treatment,and concomitant diseases.Results:(1)The data of this study included 597 males(597/638,93.6%)and 41 females(41/638,6.4%).The peak value of TSB ranged from 149.22 to 854.50 umol/L with an average value of(426.57+137.29)umol/L.The peak value of TSB≥342 umol/L was 446 cases(446/638,70.0%)and 142 cases(142/638,22.3%)with bilirubin encephalopathy.(2)Univariate analysis of TSB peak value: There were more patients with internal hemorrhage,born in County Maternal and child health care hospital and below,breast milk and mixed feeding,county level and below whose TSB peak value reached exchange blood level than those without internal hemorrhage,born in secondary comprehensive hospitals or above,artificial feeding and cities above county level,the difference was statistically significant(P<0.05).The patients with positive occult blood had more TSB peak value than those with negative TSB peak value(P<0.05).Those with TSB peak value were discharged from hospital earlier than those without exchange blood level(4.1±2.0)d,(4.7±3.4)d.The age of discovery and first diagnosis of jaundice reached the exchange level group later than that of non-exchange level group,by 2.0(2.0,3.0)d、2.0(2.0,3.0)d and3.0(2.0,5.0)d、2.0(2.0,3.0)d,the difference was statistically significant(P < 0.05).(3)Multivariate Logistic Regression Analysis of TSB Peak Value: Taking the peak value of TSB to exchange blood level as dependent variable,and the possible influencing factors(P<0.2 as inclusion criterion)as covariate(age of admission,urban and rural areas,weight of admission,birth hospital,age of discharge from maternity hospital,internal bleeding,feeding mode,age of discovery of jaundice,age of first visit,peak age of TSB,Hb,urinary bilirubin,urinary bilirubin,urinary occult blood,TSB at first visit).Multivariate logistic regression analysis found that small admission age,low level of birth hospital,internal hemorrhage,breast feeding,late onset of the first visit,late onset of the peak TSB,late onst of the TSB peak time and low Hb at admission(OR =1.110,P=0.027;OR =0.826,P=0.049;OR =0.538,P=0.035;OR =1.537,P=0.008;OR =1.183,P=0.011;OR =0.857,P=0.005;OR =0.990,P=0.000;OR =1.020,P=0.000)were high risk factors for peak TSB to exchange blood levels in G6 PD deficiency children with neonatal hyperbilirubinemia.Conclusion :(1)The incidence of moderate to severe hyperbilirubinemia and bilirubin encephalopathy in G6 PD deficiency with neonatal hyperbilirubinemia is high;males are significantly more than females,but gender is not a risk factor for peak TSB to exchange blood.(2)The independent high-risk factors for TSB peak reaching exchange blood level in G6 PD deficiency with neonatal hyperbilirubinemia are small age of admission,low grade of hospital at birth,internal bleeding,breast feeding,late initial diagnosis,late peak time of TSB,high TSB at first visit diagnosis and low Hb at admission. |
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