高膽紅素血症新生兒體重流失之相關因素探討

Abstract

背景：體重流失是造成新生兒高膽紅素血症重要因素之一，自母嬰親善醫院提倡母奶哺餵，我們觀察到新 生兒因高膽紅素血症需再入院照光治療比例有增加趨勢，因此，了解高膽紅素血症新生兒體重流失 的相關因素極其重要 目的：探討高膽紅素血症新生兒體重流失之相關因素。 方法：研究收集2015年1月1日至2019年11月30日因高膽紅素血症再入院足月新生兒共285位進行回溯性病歷研究，以描述性統計分析、獨立樣本t檢定、單因子變異數分析、Mann-Whitney U及複迴歸進行資料分析。 結果： 新生兒高膽紅素血症再入院平均體重流失率為4.47% ± 4.22%。複迴歸分析結果顯示新生兒出生體重、再入院體重、總血清膽紅素值及純母乳哺餵等為新生兒體重流失率的預測因子。 結論/實務運用：研究證實新生兒出生體重、再入院體重及總血清膽紅素值與體重流失率有相關性。臨床醫護 人員應於新生兒首次出院前確認是否有體重過度流失現象，早期檢測血清膽紅素值，教導父母出院後監測新生兒體重的變化，以避免新生兒因過度體重流失而導致高膽紅素血症再入院。  Background: Weight loss is one of major the factors in neonatal hyperbilirubinemia. Since Baby-Friendly initiatives promoted breastfeeding, we have observed an increase of neonates who need to be readmitted to the hospital for phototherapy due to hyperbilirubinemia. Therefore, it is very important to understand the related factors of weight loss in newborns with hyperbilirubinemia.Purpose: To explore the relationships between neonatal hyperbilirubinemia and body weight loss. Methods: This retrospective study enrolled 285 full-term newborns who were readmitted within one month after birth due to hyperbilirubinemia during 1st January 2015 ad 30th November 2019. Data were analyzed by independent t-test, analysis of variance, Mann-Whitney U, and multiple regression. Results: The average weight loss percentage of neonatal hyperbilirubinemia was 4.47% ± 4.22%. The results of multiple regression analysis showed that neonatal birth weight, readmission weight, total serum bilirubin and exclusive breastfeeding were the predictors of neonatal weight loss percentage. Conclusions/Implications for Practice: The study confirmed that the birth weight, readmission weight and total serum bilirubin were correlated with weight loss percentage. Clinical healthcare providers should confirm whether there is excessive weight loss before of before the infant is discharged from the hospital. Early detection of serum bilirubin and teach the parents to monitor the change of the neonatal weight after discharged could avoid the neonatal hyperbilirubinemia due to excessive weight loss.