Türkiye, Konya'da bebek dostu bir hastanede indirekt neonatal hiperbilirubinemi ve uzun fototerapi süresi ile ilişkili risk faktörleri

Öz

Giriş: İndirekt neonatal hiperbilirubinemi, dünya çapında yaygın bir yenidoğan hastalığıdır ve hızlı tedavi edilirse benign kalabilir. Bununla birlikte, tanı ve sağlık hizmetine sınırlı erişimin olduğu ortamlarda daha yüksek bir morbidite ve mortalite riski vardır. Bu çalışmanın amacı, indirekt neonatal hiperbilirubineminin etiyolojilerini değerlendirmek, fototerapi tedavisinin etkinliğini belirlemek ve uzun süreli fototerapi süresi için ilişkili risk faktörlerini belirlemektir. Gereç ve Yöntem: Çalışmaya, serum bilirubin düzeyi fototerapi tedavi eşiğinde veya üzerinde olarak tanımlanan 37≤ gebelik haftası, postnatal yaşı 14≥ gün ve başvuru anında hiperbilirübinemi tanısı olan bebekler dahil edildi. Tüm vakalar aralıklı fototerapi ile tedavi edildi. Veriler geriye dönük olarak analiz edildi ve fototerapi süresi 24≥ saat (erken taburculuk) ve 24˂ saat (geç taburculuk) olarak sınıflandırıldı. Bulgular: Çalışmaya toplam 205 yenidoğan dahil edildi. Ortalama doğum ağırlığı 3171,12±436,19 g ve ortalama gebelik yaşı 38,87±1,18 (37-39) hafta idi. Ayrıca serimizde ABO uyumsuzluğu ve sefal hematom en sık görülen etiyolojiler olarak bulundu. Diğer taraftan, erkek cinsiyet (p=0.03) ve ilk besin olarak mama kullanılması (p=0.03) geç taburculuk grubunda anlamlı olarak daha yüksekti. Bunlara ek olarak; erkek cinsiyet, ilk besin olarak mama kullanılması, ABO uyumsuzluğu, Rh izoimmünizasyonu, sefal hematom ve sepsis, 24˂ saatlik uzun fototerapi süresi için risk faktörleriydi. Sonuç ve Tartışma: Yenidoğan sarılığı için olası risk faktörlerinin belirlenmesi doğum sonrası taburculuk öncesi anneleri bilgilendirerek erken hastaneye yatışları sağlayabilir.

Anahtar Kelimeler

• yenidoğan sarılığı
• indirekt hiperbilirubinemi
• etyoloji
• fototerapi tedavisi
• risk faktörleri

Indirect neonatal hyperbilirubinemia and associated risk factors for long phototheraphy duration in a baby-friendly hospital in Konya, Turkey

Öz

Aim: Indirect neonatal hyperbilirubinemia is a common neonatal disorder worldwide which can remain benign if prompt management is available. However there is a higher morbidity and mortality risk in settings with limited access to diagnosis and care. The aim of this study was to evaluate the etiologies of indirect neonatal hyperbilirubinemia, to determine the effectiveness of phototherapy treatment and to specify the associated risk factors for prolonged phototherapy duration. Materials and Method: Infants with ≥37 weeks of gestation, postnatal age of ≤14 days, and diagnosis of hyperbilirubinemia at admission, defined as serum bilirubin level at or above the phototherapy treatment threshold were included in the study. All the study participants were treated with intermittent phototherapy. The data were retrospectively analized and duration of phototherapy was classified as ≤24 hours (early discharge) and >24 hours (late discharge). Results: A total of 205 newborns were included in the study. The mean birth weight was 3171.12±436.19 g and mean gestational age was 38.87±1.18 (37–39) weeks. Also, ABO incompatibility and cephalic hematoma were found to be the most common etiologies in our series. On the other hand, male gender (p=0.03) and formula as the first prelacteal feeds (p=0.03) were significantly higher in late discharge group. Additionally; male gender, formula as the first prelacteal feed, ABO incompatibility, Rh isoimmunization, cephalic hematoma and sepsis were risk factors for long phototherapy duration of >24 hours. Discussion and Conclusion: Determination of possible risk factors for neonatal jaundice can provide early hospital admissions by informing mothers before discharge after birth.

Anahtar Kelimeler

• Neonatal jaundice
• indirect hyperbilirubinemia
• etiology
• phototheraphy treatment
• risk factors

Kaynakça

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