背景:新生儿黄疸是新生儿疾病和死亡的重要原因,导致新生儿重症监护病房频繁入院。为了更好地理解这个问题,在埃塞俄比亚东北部Dessie和Woldia综合性专科医院收治的新生儿中,进行了一项研究,以确定导致新生儿黄疸的因素.
方法:该研究于2022年4月1日至5月30日进行,使用无与伦比的病例对照设计。共有320名与母亲配对的新生儿参与其中,包括64例病例和256例对照。数据是通过结构化的面试官管理的问卷和病历审查收集的。采用SPSS第23版对收集到的资料进行统计分析,采用多因素logistic回归模型,了解独立因素与新生儿黄疸发生的关系。在P值小于0.05的阈值下确定统计学显著性。
结果:研究结果显示,年龄超过35岁的产妇,居住在城市地区[调整后优势比(AOR)=2.4,95%置信区间(CI):1.23,4.82],男性(AOR=4.3,95%CI:1.90,9.74),早产(AOR=3.9,95%CI:1.88,8.09),ABO不相容性(AOR=2.6,95%CI:1.16,5.96)是新生儿黄疸的重要决定因素。相反,研究表明,与阴道分娩相比,剖宫产发生婴儿黄疸的可能性降低76%(AOR=0.24,95%CI:0.08,0.72).
结论:为了预防,诊断,有效治疗新生儿黄疸,工作应主要集中在管理ABO不兼容和早期发现早产。此外,应特别注意通过阴道分娩出生的新生儿,那些母亲超过35岁的人,那些居住在城市地区的人,因为他们患新生儿黄疸的风险较高。在产前和产后期间密切监测高危母婴对,随着早期干预,在这项研究中,对于降低新生儿黄疸的严重程度至关重要。
BACKGROUND: Neonatal jaundice is a significant contributor to illness and death in newborns, leading to frequent admissions to neonatal intensive care units. To better understand this issue, a study was conducted to identify the factors contributing to neonatal jaundice among newborns admitted to Dessie and Woldia comprehensive specialized hospitals in northeast Ethiopia.
METHODS: The study took place from April 1 to May 30, 2022, using unmatched
case-control design. A total of 320 neonates paired with their mothers were involved, including 64 cases and 256 controls. Data were collected through a structured interviewer-administered questionnaire and a review of medical records. The collected data were analyzed using SPSS Version 23, and a multivariate logistic regression model was employed to understand the relationship between independent factors and the occurrence of neonatal jaundice. Statistical significance was determined at a threshold of P value less than 0.05.
RESULTS: The study findings revealed that maternal age over 35 years, residing in urban areas [adjusted odds ratio (AOR) = 2.4, 95% confidence interval (CI): 1.23, 4.82], male gender (AOR = 4.3, 95% CI: 1.90, 9.74),
prematurity (AOR = 3.9, 95% CI: 1.88, 8.09), and ABO incompatibility (AOR = 2.6, 95% CI: 1.16, 5.96) were significant determinants of neonatal jaundice. Conversely, the study indicated that cesarean birth was associated with a 76% lower likelihood of infant jaundice compared to vaginal delivery (AOR = 0.24, 95% CI: 0.08, 0.72).
CONCLUSIONS: To prevent, diagnose, and treat neonatal jaundice effectively, efforts should primarily focus on managing ABO incompatibility and early detection of
prematurity. Additionally, special attention should be given to neonates born through vaginal delivery, those with mothers over 35 years old, and those residing in urban areas, as they are at higher risk of developing newborn jaundice. Close monitoring of high-risk mother-infant pairs during the antenatal and postnatal periods, along with early intervention, is crucial for reducing the severity of neonatal jaundice in this study setting.