Clinical factors related to bilirubin encephalopathy in preterm infants: A case-control study

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2025-02-27 DOI:10.1016/j.braindev.2025.104342

Akihisa Okumura , Masahiro Hayakawa , Hiroshi Arai , Yoshihiro Maruo , Takashi Kusaka , Tetsuya Kunikata , Sota Iwatani , Yoshiaki Sato , Ichiro Morioka

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引用次数: 0

Abstract

Objectives

Bilirubin encephalopathy in preterm infants (pBE) is becoming a growing concern in Japanese neonatal intensive care units. Definitive conclusions regarding the risk factors of pBE remain elusive. This study aimed to identify the risk factors for pBE.

Methods

We performed a 1:2 matched-pair analysis, selecting infants with pBE from previous nationwide surveys and matching them with control infants without evident neurodevelopmental delay based on year of birth, gestational age, or birth weight. We compared demographic data, neonatal complications, laboratory data within the first 8 weeks of life, and phototherapy between the two groups.

Results

We analyzed 20 infants with pBE and 40 control infants. Infants with pBE showed higher frequencies of bronchopulmonary dysplasia, gastrointestinal complications (excluding necrotizing enterocolitis), and bacteremia than the controls. Infants with pBE had higher peak total bilirubin levels and bilirubin/albumin ratios, alongside lower bottom albumin levels than controls. The difference in these laboratory values was prominent during the third to fourth weeks of life. Infants with pBE ended phototherapy significantly later than the controls. Multiple regression analysis showed that bronchopulmonary dysplasia, bacteremia, and peak total bilirubin levels were independently associated with pBE.

Conclusions

Bronchopulmonary dysplasia, bacteremia, and peak total bilirubin values were presumed to be associated with the occurrence of pBE. The results of this study will improve treatment approaches for neonatal jaundice in preterm infants.

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与早产儿胆红素脑病相关的临床因素：一项病例对照研究

目的：胆红素脑病（pBE）在日本新生儿重症监护病房日益受到关注。关于pBE危险因素的明确结论仍然难以捉摸。本研究旨在确定pBE的危险因素。方法采用1:2配对分析，从全国范围内的调查中选择pBE患儿，并根据出生年份、胎龄或出生体重将其与无明显神经发育迟缓的对照患儿进行配对。我们比较了两组的人口统计数据、新生儿并发症、出生后8周内的实验室数据和光疗数据。结果我们分析了20例pBE患儿和40例对照患儿。与对照组相比，pBE患儿出现支气管肺发育不良、胃肠道并发症（不包括坏死性小肠结肠炎）和菌血症的频率更高。与对照组相比，pBE患儿的总胆红素峰值水平和胆红素/白蛋白比值较高，同时底部白蛋白水平较低。这些实验室值的差异在生命的第三至第四周时尤为突出。pBE患儿结束光疗的时间明显晚于对照组。多元回归分析显示，支气管肺发育不良、菌血症和总胆红素峰值水平与pBE独立相关。结论支气管肺发育不良、菌血症和总胆红素峰值与pBE的发生有关。本研究结果将改善早产儿新生儿黄疸的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.