新生儿高胆红素血症与剖宫产相关性分析

目的探讨新生儿高胆红素血症(简称"高胆")发生与围生期高危因素尤其剖宫产的关系。方法以产科出生的519例新生儿为研究对象,对发生高胆和无高胆的新生儿围生期高危因素进行对照分析。结果影响新生儿高胆的高危因素包括:男性、小于37周的早产儿、低体重儿、产前用催产素、妊期疾病、脐带绕颈、窒息、吸入综合征(P均<0.05)。经Logistic回归分析进入回归模型的危险因子依其比数比由大到小排列为:<37周早产儿、窒息、吸入综合征、产前用催产素;剖宫产因素对高疸的发生无直接影响,但在与其它高危因素相互作用时,则显示为间接双重性影响,即对新生儿高胆的发生既有促进,亦有降低其发生风险性的双重作用。结论积极防治围生期高危因素,掌握好剖宫产的临床指征,对减少新生儿高胆的发生是重要可行的措施。

A correlative analyisis of newborn hyperbilirubinemia and cesarean section

Objective To explore the correlation of newborn hyperbilirubinemia and perinatal high- risk factors especially cesarean section factor. Methods Perinatal high - risk factors were analyzed controlly in 519 newborn infants with hyperbilirubinemia and non- hyperbilirubinemia. Results The perinatal factors of hyperbiliru binemia including： male, premature infant less than 37 weeks, low birth weight infant, oxitocin induction of mothers, pregnant disease, cord around neck, asphyxia, aspiration syndrome （all P 〈 0.05）. After Logistic regression analysis, the risk factors entered in regression models ranked from high to low according to the ratio were： premature infant less than 37 weeks, asphyxia, aspiration syndrome, oxitocin induction of mothers. The factor of cesarean section had no directly impacts on the incidence of newborn hyperbilirubinemia, but had indirectly dual effects when the factor of cesarean section interacted with another perinatal high - risk factors; which had favorable and unfavorable influences. Conclusion They are important and feasible measures to prevent and to treat perinatal high- risk factors, and to master the indication of cesarean section for reducing the incidence of newborn hyperbilirubinemia.