Analysis Of Risk Factors Of Neonatal Severe Jaundice Based On Blood Exchange Standard

Objective:The clinical data of neonatal pathological jaundice were retrospectively analyzed to explore the risk factors of neonates with severe jaundice up to the standards of blood exchange,so as to provide reference for the prevention and treatment of neonates with severe jaundice up to the standards of blood exchange,so as to effectively reduce the incidence of bilirubin encephalopathy.Methods:Retrospective analysis was performed on the data of neonates with pathological jaundice who were hospitalized in the Department of Neonatology,Renmin University Hospital affiliated to Hubei University for Nationalities from January 1,2016 to December 31,2020.The neonates with severe jaundice who were hospitalized in our center during January 1,2016 to December31,2020 were selected as the observation group.Simple random sampling method was used to select the corresponding cases of neonatal pathological jaundice who were hospitalized at the same period but did not meet the standards of blood exchange as the control group.SPSS17.0 statistical software was used to conduct univariate analysis and Logistic regression analysis on their clinical data,to identify the risk factors of neonatal severe jaundice that met the standards of blood exchange.Results:1.Univariate analysis of neonatal severe jaundice up to the standard of blood exchange showed that: Preterm birth,place of residence,ethnic minority,place of birth,time of milk opening,parents’ education level,mother’s bad habits during pregnancy,early treatment,hemolytic disease,hemorrhagic disease,history of asphyxia and hypoxia at birth,there were statistically significant differences between the group meeting the blood exchange standards and the group not meeting the blood exchange standards（P < 0.05）.There were statistically significant differences in length of hospitalization,hospitalization cost and incidence of bilirubin encephalopathy between the two groups（P < 0.05）.2.Multivariate Logistic regression analysis results show that: Hemolytic disease（P=0.000,OR=19.525）,hemorrhagic disease（P=0.002,OR=8.510）,milk opening time（P=0.007,OR=3.867）,course of disease（P=0.002,OR=1.217）,ethnic minority（P=0.009,OR=5.734）,all had statistical significance.It is an independent risk factor for severe neonatal jaundice up to the standard of blood exchange.3.According to ROC analysis of independent risk factors,it was found that under the curve area hemolytic disease was 0.717,course of disease was 0.659,milk opening time was0.649,hemorrhagic disease was 0.608,and minority nationality was 0.601,the difference was statistically significant compared with 0.5（P < 0.05）.4.In the outcome analysis of whether the neonates with severe jaundice received active blood exchange therapy or not,it was found that there was statistically significant difference in the incidence of bilirubin encephalopathy between the two groups of neonates with or without blood exchange therapy（P=0.019 <0.05）.Conclusion: Hemolytic disease,hemorrhagic disease,delayed milk opening and long course of disease were independent risk factors for severe jaundice in neonates meeting blood exchange standards,and ethnic minorities were also independent risk factors for severe jaundice in neonates meeting blood exchange standards.All these independent risk factors had predictive significance for severe jaundice in neonates meeting blood exchange standards.