Analysis Of The Etiology And Related Factors Of Neonatal Hyperbilirubinemia

Objective:To retrospectively analyze the clinical data of 377 cases of neonatal hyperbilirubinemia in our neonatal unit,to explore the common causes of neonatal hyperbilirubinemia and related factors,and to analyze the risk factors for the development of severe hyperbilirubinemia and the risk factors for the development of bilirubin encephalopathy in severe hyperbilirubinemia.Methods:Three hundred and seventy-seven term neonates with hyperbilirubinemia admitted to the neonatal unit of our hospital between 01 January 2020 and 31 December 2022 were selected for the study.The cases were divided into severe hyperbilirubinemia group and non-severe hyperbilirubinemia group according to whether the peak total bilirubin reached 342 μmol/L(20 mg/dl);the cases in the severe hyperbilirubinemia group were divided into bilirubin encephalopathy group and non-bilirubin encephalopathy group according to whether bilirubin encephalopathy occurred.Clinical data of the children and mothers were collected by creating a neonatal hyperbilirubinemia survey form.The data were statistically processed with a test level of α = 0.05,with P < 0.05 indicating a statistically significant difference.Indicators that differed between groups were included in a dichotomous variable logistic regression model analysis,with results expressed as ORs and 95% confidence intervals.Results:1.The common causes of neonatal hyperbilirubinemia were perinatal factors in 103cases(21.5%),including 35 cases of intracranial hematoma,28 cases of premature rupture of membranes,18 cases of intrauterine distress,15 cases of intracranial hemorrhage,7 cases of asphyxia;93 cases(19.5%)received less than the required amount.92 cases(19.2%)were acidosis;92 cases(19.2%)had unknown causes.2.Comparison of clinical characteristics between the severe NHB group and the non-severe NHB group: After statistical analysis of the etiology,clinical data of the children,clinical data of the pregnant mothers and comorbidities,most of the children in the severe NHB group came from outside the hospital,were older at the time of admission and had a longer hospital stay,and the difference was statistically significant(P < 0.05).Feeding practices,inadequate intake,unknown cause and maternal hypertensive disorders of pregnancy differed between the two groups,with a statistically significant difference(p <0.05).Hearing screening,neonatal behavioural neurological measurements and video EEG results were compared between the two groups and the differences were not statistically significant(p > 0.05).Multi-factor logistic regression analysis showed that out-of-hospital origin and unknown cause of the child were risk factors for the development of severe NHB,with ORs and 95% confidence intervals of 8.44(4.418-16.137)and 2.988(1.283-6.958)respectively.3.Comparison of clinical characteristics between the bilirubin encephalopathy and non-bilirubin encephalopathy groups: After statistical analysis of the etiology,clinical data of the child,clinical data of the pregnant mother and comorbidities,the jaundice appeared earlier and the length of hospital stay was longer in the bilirubin encephalopathy group compared to the non-bilirubin encephalopathy group,with a statistically significant difference(p < 0.05).Inadequate admission and the presence of maternal risk factors for infection differed between the two groups,with a statistically significant difference(p < 0.05).Hearing screening,neonatal behavioural neurological measurements and video EEG results were compared between the two groups and the differences were not statistically significant(p > 0.05).Multi-factor logistic regression analysis showed that inadequate intake was a risk factor for the development of bilirubin encephalopathy in children with severe hyperbilirubinemia,with an OR and 95% confidence interval of 7.667(2.094-28.068).Conclusion:1.The common diseases of neonatal hyperbilirubinemia in our hospital are perinatal factors,insufficient intake,acidosis and unknown causes.2.Out-of-hospital and unknown causes were risk factors for severe hyperbilirubinemia.3.Insufficient intake is a risk factor for bilirubin encephalopathy in severe hyperbilirubinemia.