妊娠期使用地塞米松对新生儿胆红素水平的影响  

Effect of dexamethasone on neonatal bilirubin level during pregnancy

作　　者：邱爱娟[1] 潘兆军[1] 杨利丽[1] 陈晓涛[1] QIU Aijuan;PAN Zhaojun;YANG Lili;CHEN Xiaotao(Department of Neonatology,Huai'an Maternal and Child Health Hospital,Huaian,Jiangsu 223000,China)

机构地区：[1]淮安市妇幼保健院新生儿科,江苏淮安223000

出　　处：《中国优生与遗传杂志》2023年第1期159-163,共5页Chinese Journal of Birth Health & Heredity

基　　金：江苏省妇幼健康科研项目(F201746)。

摘　　要：目的分析新生儿高胆红素血症(NHB)的围生期风险因素,探讨妊娠期使用地塞米松对新生儿胆红素水平的影响,为产科和儿科临床实践提供参考。方法研究纳入2020年1月1日至2022年1月1日淮安市妇幼保健院新生儿科生产的390例新生儿,回顾围生期临床资料。首先进行病例对照研究,根据新生儿生后胆红素水平是否达到NHB的诊断标准,将其分为NHB组和正常对照组。进行两组间各临床指标的单因素和多因素Logistic回归分析,找到影响NHB的独立风险因素。再进行历史性队列研究,通过孕产妇妊娠期是否暴露于地塞米松,将队列分为地塞米松暴露组与非暴露组,对比两组孕产妇生产的新生儿前三天经皮胆红素水平。结果病例对照研究单因素分析中,NHB组新生儿出生体质量、胎龄显著低于正常对照组、剖宫产比例显著高于正常对照组;NHB组既往流产史、妊娠高血压、注射地塞米松比例显著高于正常对照组;多因素分析显示,胎龄<37周、妊娠期注射地塞米松以及剖宫产均为新生儿NHB的独立风险因素。队列研究结果表明,相较非暴露组,妊娠期地塞米松暴露组新生儿生后1、2、3天的经皮胆红素水平均显著升高。结论妊娠期孕产妇接受地塞米松注射可导致新生儿生后胆红素水平显著上升,是引起NHB的独立风险因素。Objective To analyze the perinatal risk factors of neonatal hyperhyperbilirubinemia(NHB),and to explore the effect of dexamethasone use during pregnancy on neonatal bilirubin level,so as to provide reference for clinical practice in obstetrics and pediatrics.Methods A total of 390 neonates born in Department of Neonatology,Huai’an Maternal and Child Health Hospital from January 1,2020 to January 1,2022 were included in this study.The perinatal clinical data were reviewed.A case-control study was conducted first.Neonates were divided into NHB group and normal control group according to whether their post-birth bilirubin level reached the diagnostic criteria of NHB.Univariate and multivariate Logistic regression analysis were performed to identify the independent risk factors for NHB between the two groups.Then a historical cohort study was conducted.According to whether the pregnant women were exposed to dexamethasone during pregnancy,the cohort was divided into the dexamethasone exposure group and the non-exposure group,and the transcutaneous bilirubin levels in the first three days of neonatal delivery were compared between the two groups.Results In the univariate analysis of case-control study,the birth weight and gestational age of neonates in NHB group were significantly lower than those in normal control group,and the proportion of cesarean section was significantly higher than that in normal control group.The proportion of previous abortion history,gestational hypertension and dexamethasone injection in NHB group were significantly higher than those in normal control group.Multivariate analysis showed that gestational age<37 weeks,dexamethasone injection during pregnancy,and cesarean section were independent risk factors for neonatal NHB.The results of the cohort study showed that compared with the non-exposed group,the percutaneous bilirubin level of neonates in the gestational dexamethasone exposure group was significantly higher at 1,2,and 3 days after birth.Conclusion Dexamethasone treatment during pr

关 键 词：新生儿高胆红素血症 风险因素 早产 地塞米松 剖宫产 

分 类 号：R722.1[医药卫生—儿科]