尼日利亚西南部提供免费医疗服务的二级医疗机构中新生儿黄疸的患病率、风险因素和短期结果

R. Oluwafemi, M. Abiodun, J. Owa
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引用次数: 1

摘要

背景:新生儿黄疸(NNJ)是全世界约60%足月婴儿和80%早产儿的常见病,也是生命第一周住院治疗的主要原因。现有证据表明,与高收入国家相比,低收入和中等收入国家的新生儿严重黄疸负担最重,其特点是发病率、死亡率和长期后遗症非常高。目的:记录尼日利亚西南部提供免费医疗服务的二级医疗机构中新生儿黄疸的患病率、风险因素和短期结局。方法:从特殊护理婴儿病房(SCBU)的出生臂和出生臂招募婴儿。这是一项前瞻性研究,纳入2014年1月至12月所有因新生儿黄疸入院的婴儿;这些婴儿一直随访到出院。收集患者信息,包括社会人口统计学特征、危险因素、治疗方式和结果,并直接输入到Excel表格中。结果:共有1309人入学,其中男性734人,女性575人,男女比例为1.3:1。其中125例(9.5%)存在NNJ。35例(28%)为早产儿,90例(72%)为足月婴儿。其中10例(8%)在出生后24小时内出现,103例(82.4%)在出生后第1天至第7天出现,12例(9.6%)在出生后第7天出现。新生儿脓毒症、早产、围产期窒息和长时间膜破裂(PROM)是本研究中NNJ的主要原因和危险因素。仅采用光疗治疗的有107例(85.6%),采用换血治疗的有18例(14.4%)。120例(96%)患儿存活出院,5例(4%)患儿发生胆红素脑病,2例(1.6%)患儿死亡。结论:新生儿黄疸在我们的环境中很常见,可能会带来可怕的后果。需要对公众进行健康教育,使其了解相关的可改变的危险因素。
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Prevalence, risk factors and short-term outcome of babies with Neonatal Jaundice in a secondary facility with free-health services in South-West, Nigeria
Background: Neonatal Jaundice (NNJ) is a common occurrence in about 60% of term infants and 80% of preterm infants worldwide and a leading cause of hospitalization during the first week of life. Available evidence suggests that lowand middle-income countries (LMICs) bear the greatest burden of severe neonatal jaundice characterized by very high rates of morbidity, mortality and long-term sequel compared to high-income countries (HICs). Aims: To document the prevalence, risk factors and short-term outcome of babies with neonatal jaundice in a secondary health facility with free health services in South-West Nigeria. Method: Babies were recruited from both in-born and out-born arms of the Special Care Baby Unit (SCBU). It was a prospective study of all babies admitted for neonatal jaundice from January to December 2014; the babies were followed up till discharge. Patients’ information including socio-demographic characteristics, risk factors, treatment modalities and outcomes were collected and entered directly into an Excel sheet. Results: There were a total of 1,309 admissions: 734 males and 575 females giving a M: F ratio of 1.3:1. NNJ was present in 125 (9.5%) of them. Thirty-five (28%) of the affected babies were preterm babies while 90 (72%) were term babies. Ten (8%) of them presented within the first 24 hours of life, 103 babies (82.4%) presented between 1st and 7th day of life while 12 (9.6%) presented after the 7th day of life. Neonatal sepsis, prematurity, perinatal asphyxia and prolonged rupture of membrane (PROM) were the leading causes and risk factors for NNJ in our setting. One hundred and seven (85.6%) of them had only phototherapy as treatment modality while 18 (14.4%) had exchange blood transfusion (EBT). One hundred and twenty babies (96%) were discharged alive, 5 (4%) had bilirubin encephalopathy and 2 babies (1.6%) died. Conclusion: Neonatal Jaundice is common in our setting with possible dire consequences. Health education of the public on its associated modifiable risk factors is desirable.
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