剖宫产与新生儿高胆红素血症病例对照研究

目的探讨剖宫产分娩与新生儿高胆红素血症(简称,高胆)的关系。方法对我院2003年1月至2004年12月期间在产科出生的新生儿进行病例对照研究,通过监测经皮胆红素、血清胆红素,比较剖宫产与非剖宫产娩出新生儿发生高胆的情况。结果多因素分析结果显示影响新生儿高胆红素血症的因素包括:剖宫产、母乳缺乏、生后头3天体重下降明显、高龄初产、胎龄、宫内窘迫等,剖宫产组新生儿高胆发生率为36.9%,非剖宫产组新生儿高胆发生率为21.8%,两者差异有显著性(P<0.01)。剖宫产组中母亲有妊高征者新生儿高胆发生率略高于母亲无妊高征者,两者间差异无显著性(P>0.05);两组患儿合并窒息、缺氧缺血性脑病(HIE)、吸入综合征、感染等疾病对高胆的影响差异无显著性(P>0.05)。结论剖宫产可能是引起新生儿高胆的原因之一。

Cohort study of the relationship between cesarean section delivery and neonatal hyperbilirubinemia

Objective To explore the relationship between cesarean section delivery and neonatal hyperbilirubineura. Methods Babies were born in our hospital from January 2003 to December 2004. They were delivered either by cesareansection or vaginally. Percutaneous and serum bilirubin levels were monitored to compare the morbidity of neonatal hyperbilirubinemia in them. Results Multi-factor regression analysis showed that cesarean section delivery, no enough breast feeding, loss of weight greatly in first three days, senior age of mother, gestational age and fetal distress were influencing factors of neonatal hyperbilirubinemia. The neonatal hyperbilirubinemia mobidity in cesareansection group was higher than that in vaginal delivery group, 36.9% vs, 21.8%, P<0.01. No relationship was noted between hyperbilirubinemia and neonatal asphyxia, hypoxic ischemic encephalopathy, aspiration syndrome and infectious diseases. Conclusions Cesarean section delivery may be one of risk factors of neonatal hyperbilirubinemia.