| Objective: To summarize the occurrence of neonatal ABO Hemolytic disease of the newborn(HDN)complicated with neonatal necrotizing enterocolitis(NEC)in Northwest Women's and Children's Hospital,to explore possible high-risk factors for the prevention and treatment of HDN Concurrent NEC provides a certain basis.Objects and methods: A retrospective investigation and study method of clinical epidemiology was adopted.From May 2015 to January 2019,the first diagnosis of HDN in the neonatal department of Northwest Women's and Children's Hospital was selected as the research object.A total of 817 children were included.Summarize from the aspects of gender,birth history,maternal obstetric comorbidities,neonatal comorbidities,treatment methods,related auxiliary examinations,etc.,and divide the case samples into NEC group and non-NEC group according to whether the children have combined NEC in the course of the disease,and then further Analyze the differences between the maternal perinatal factors and obstetric comorbidities,neonatal complications and treatment methods,blood routine and liver function,IVIG(Intravenous immunoglobulin G)application of two groups of HDN children,and summarize the high risk of HND with NEC factor.Relevant factors were first screened by single factor analysis,and then meaningful variables were further analyzed by multivariate logistic regression model to obtain the risk factors of HND and NEC.Results:1.Among the 817 subjects in our hospital,60 had NEC and 757 had no NEC;the incidence of HDN complicated NEC was 7.3%.2.Statistical results of comparison between groups:(1)Birth history and comorbidities during maternal and pregnancy: The NEC group of children with maternal non-first childbirth history,cesarean section,and birth amniotic fluid pollution were higher than non-NEC group,with statistical significance(P<0.05);(2)Children's complications: The anemia and hypokalemia in the NEC group were higher than those in the non-NEC group,with statistical significance(P<0.05);(3)In terms of treatment plan: The intravenous nutrition,antibiotics,IVIG of children in the NEC group was higher than that in the non-NEC group,and the use of probiotics was lower in the non-NEC group,with statistically significant(P<0.05);(4)Auxiliary examination: NEC combination with eosinophilia is higher than non-NEC group,with statistical significance(P<0.05);3.Multivariate logistic regression model analysis: in terms of comorbidities and treatment methods of children,the regression coefficients of cesarean section,anemia,hypokalemia,and IVIG> 1,cesarean section(OR = 2.681,95% CI: 1.843-5.355,P = 0.00),anemia(OR =3.568,95% CI: 1.802-7.065,P = 0.000),hypokalemia(OR = 2.497 95% CI: 0.663-4.693,P= 0.108),IVIG(OR=3.861 95% CI: 1.960-7.605,P=0.000),eosinophilia(OR=1.180 95%CI: 1.0.663-3.717,P =0.000)OR> 1,to increase neonatal ABO The high-risk factor of hemolytic disease complicated with NEC,probiotic regression coefficient <1(OR=0.74995% CI: 0.749-1.082,P=0.040),is the protective factor of HDN complicated NEC.Conclusions:HDN patients with maternal non-first delivery,cesarean section,birth amniotic fluid contamination,neonatal comorbid anemia,eosinophilia,and hypokalemia are more likely to have NEC.We should promptly adopt supportive measures such as breastfeeding and oral probiotics.During treatment,such as intravenous IVIG,avoid large doses.It is recommended to breastfeed,reduce the amount of milk when IVIG is dripped,and do not increase the amount of milk temporarily after IVIG.For children with high-risk factors,closely observe the feeding tolerance during treatment,reduce the incidence of HDN,and reduce the severity of the occurrence. |
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