| Summary: | 碩士 === 亞洲大學 === 健康產業管理學系健康管理組碩士在職專班 === 101 === Background: Although most newborns develop some degree of neonatal jaundice and is usually benign. Healthy, full-term infants are expected to lose weight in the first days following birth. Poor caloric intake can cause excessive weight loss in the first days of life and may contribute to the development of hyperbilirubinemia, and associated with the most prevalent diagnosis for readmission.
Objective: To analyze what constitutes normal neonatal weight loss, and when extra supplemental feedings should be considered to prevent significant hyperbilirubinemia.
Methods: We conducted a retrospective chart review from January 2007 to December 2008, healthy, term newborns with a gestational age of more than 37 weeks and a birth body weight above 2500 gm were enrolled. We analyzed the association between body weight loss (BWL) percentage and significant hyperbilirubinemia (total bilirubin more than 15 mg/dL) 72 hours after birth, and receiver operating characteristic (ROC) curves were used to evaluate the appropriate cut-off BWL percentages on the first three days after birth for the prediction of neonatal hyperbilirubinemia 72 hours after birth.
Results: During the study period, 343 neonates were enrolled in our analysis. The mean birth body weight was 3119±352 gm, and the mean BWL percentage on day 3 was 7.07± 2.82%. In addition, 115(33.5%) of the newborns presented with significant hyperbilirubinemia 72 hours after birth. The mean BWL percentage on day 3 was 8.4±2.54%, and the mean total serum bilirubin（TSB）level was 16.8±1.36mg/dl (all p< 0.05) in the significant hyperbilirubinemia group. The BWL percentages within the first 3 days after birth all showed a significant correlation with significant hyperbilirubinemia 72 hours after birth. To predict significant hyperbilirubinemia 72 hours after birth, ROC analysis showed that the optimum cut-off points of BWL percentage were 3.32% on the first day of life (day 1) (sensitivity 68.7%; specificity 45.61%), 7.60% on day 2 (sensitivity 46.96%; specificity 74.12%) and 8.15% on day 3 (sensitivity 57.39%; specificity 70.18%) (all p< 0.05).
Conclusions: BWL percentages on the first three days after birth may serve as a predisposing factor for hyperbilirubinemia, and may also be a useful predicting factor for significant hyperbilirubinemia 72 hours after birth.
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