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Predicting Nonhemol...
Predicting Nonhemolytic Neonatal Hyperbilirubinemia
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- Norman, M (författare)
- Karolinska Institutet
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- Aberg, K (författare)
- Karolinska Institutet
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Holmsten, K (författare)
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Weibel, V (författare)
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- Ekeus, C (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2015-12-01
- 2015
- Engelska.
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 136:6, s. 1087-1094
- Relaterad länk:
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http://kipublication...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Before hospital discharge, newborn infants should be assessed for the risk of excessive hyperbilirubinemia. We determined maternal and obstetric risk factors for hyperbilirubinemia in infants born at term (gestational age ≥37 weeks) to form an individualized risk assessment tool for clinical use.METHODS:This was a population-based study with data from the Swedish Medical Birth Register from 1999 to 2012, including 1 261 948 singleton infants. Outcome was defined as infants diagnosed with hyperbilirubinemia (N = 23 711), excluding all cases of hemolytic (immune-mediated or other specified hemolytic) diseases of the newborn.RESULTS:Risk factors with an adjusted odds ratio (aOR) for neonatal hyperbilirubinemia of ≥1.5 (medium-sized effect or more) were gestational age 37 to 38 weeks (aOR = 2.83), failed vacuum extraction (aOR = 2.79), vacuum extraction (aOR = 2.22), Asian mother (aOR = 2.09), primipara (aOR = 2.06), large-for-gestational-age infant (aOR = 1.84), obese mother (aOR = 1.83), and small-for-gestational-age infant (aOR = 1.66). Planned cesarean delivery (CD) was associated with a reduced risk (aOR = 0.45). Without any of these risk factors (normal birth weight infant delivered vaginally at 39 to 41 weeks’ gestation by a non-Asian, nonobese, multiparous mother) the rate of nonhemolytic neonatal hyperbilirubinemia was 0.7%. In relation to the combined load of different risk factors, rates of neonatal hyperbilirubinemia ranged from 0.2% to 25%.CONCLUSIONS:Collection of a few easily available maternal and obstetric risk factors predicts >100-fold variation in the incidence of neonatal hyperbilirubinemia. The information provided herein enables individualized risk prediction with interactions between different risk factors taken into account.
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