Journal of Developmental Medicine(Electronic Version)  2025, Vol. 13 Issue (1): 47-55 DOI: 10.3969/j.issn.2095-5340.2025.01.007 |
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| Effect of hemoglobin on neonatal hyperbilirubinemia complicated with acute bilirubin encephalopathy based on latent class analysis |
| Yang Xiaoting, Wang Zhen, Chen Yan
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Department of Pediatrics, Hefei BOE Hospital, Anhui, Hefei 231000, China
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Abstract 【Abstract】 Objective To investigate the distribution characteristics of the influencing factorsof acute bilirubin encephalopathy (ABE) in hyperbilirubinemia children with different hemoglobin
expression levels based on latent class analysis. Method A total of 180 neonates with neonatal
hyperbilirubinemia admitted to neonatal intensive care unit (NICU) in Hefei BOE Hospital from January 2015 to January 2023 were retrospectively selected as the study objects. They were divided
into ABE group (n=48) and non-ABE group (n=132) according to whether ABE occurred or not. The
general data, blood routine indexes and renal function indexes of the two groups were compared and
analyzed. Multivariate Logistic regression analysis was used to explore the independent influencing factors
of ABE in children with hyperbilirubinemia and the independent correlation between hemoglobin and ABE.
The distribution characteristics of influencing factors of ABE in hyperbilirubinemia children with different
hemoglobin expression levels were compared by latent class analysis. Statistical methods performed by t-test, χ2 test. Result The incidence of ABE in 180 children with hyperbilirubinemia was 26.67% (48/180).The gestational age of children in ABE group was lower than that in non-ABE group [(38.2±0.6) weeksvs (38.5±0.6) weeks, t=2.484, P<0.05], and the proportion of normal birth in ABE group was lower thanthat in non-ABE group [43.75% (21/48) vs 62.88% (83/132), χ2=5.280, P<0.05]. The levels of hemoglobin,hematocrit (HCT) and total serum bilirubin (TSB) in ABE group were higher than those in non-ABE group[(163±12) g/L vs (159±11) g/L, (48.2±7.8)% vs (45.1±6.5)%, (368.7±22.8) μmol/L vs (358.7±19.8)μmol/L, t=2.274, 2.437, 2.676, all P<0.05]. The proportion of ABO hemolysis, Rh hemolysis and sepsis inABE group were higher than those in the non-ABE group [16.67% (8/48) and 5.30% (7/132), 8.33% (4/48)and 1.52% (2/132), 6.25% (3/48) and 0.76% (1/132) , χ2=5.950, 5.078 and 4.887, all P<0.05]. MultivariateLogistic regression analysis showed that hemoglobin, HCT, TSB, ABO hemolysis and Rh hemolysis wereindependent risk factors for children with hyperbilirubinemia complicated with ABE. The results of clusteranalysis showed that the children with hyperbilirubinemia combined with ABE showed obvious aggregation.The children with hyperbilirubinemia were divided into high-risk group combined with ABE (hemoglobin≥159.5 g/L) and low-risk group combined with ABE (hemoglobin <159.5 g/L), the recurrence rate was46.67% (35/75) and 12.38% (13/105), respectively, and the difference was statistically significant (P<0.05).The results of latent class analysis showed that the factors combining with ABE high-risk group and low-riskgroup could be aggregated into three latent class distribution patterns. The proportion of children with"less distribution of risk factors" in the high-risk group combined with ABE was significantly lower thanthat in the low-risk group combined with ABE, and the proportion of children with "higher hemoglobindistribution" was significantly higher than that in the low-risk group combined with ABE. There was nosignificant difference in the proportion of children with "low hemoglobin distribution" between the two groups (P>0.05). Conclusion Hyperbilirubinemia children with high hemoglobin expression level should be alert to the occurrence of ABE and take targeted measures to improve the diagnosis and prognosis of ABE.
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Received: 14 August 2023
Published: 26 January 2025
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