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| Risk factors associated with the acute bilirubin encephalopathy of neonates: a metaanalysis |
| 1.Taihe Hospital Affiliate to Hubei University of Medicine, Shiyan, Hubei Province, 442008; 2.Shenzhen Maternal and Child Health Care Hospital，Shenzhen |
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Abstract To explore the risk factors associated with the acute bilirubin encephalopathy (ABE) of neonates by a meta-analysis, and to provide the theoretical evidences for the early identification and treatment of the neonatal ABE. Methods: The relevant studies were retrieved from the databases of Wanfang Data, CNKI, VIP, PubMed, Web of Science, Embase and Cochrane Library from the establishment time of these databases to August 1, 2023. The literatures were screened according to the inclusion and exclusion criteria, and the relevant data in the included literatures were extracted. The meta-analysis was performed by RevMan 5.3 software. Results: Finally, 30 clinical studies were included in this meta-analysis, and which involving 12,965 neonates. The meta-analysis results showed that a total of 15 risk factors were identified. The peak value of the total serum bilirubin (OR=1.27, 95% CI 1.21-1.34), the total serum bilirubin/albumin ratio (OR=1.47, 95% CI 1.21-1.79), the jaundice value within 24 hours (OR=6.03, 95% CI 2.73-13.32), the ABO or Rh hemolysis rate (OR=3.31, 95% CI 2.57-4.26), the high level of hemoglobin (OR=1.05, 95%CI 1.01-1.11), the glucose-6-phosphate ehydrogenase deficiency rate (OR=3.82, 95%CI 1.98-7.37), the perinatal hypoxia rate (OR=12.20, 95%CI 1.95-76.27), the sepsis rate (OR=3.13, 95%CI 1.98-4.95), the infection rate (OR=4.99, 95%CI 3.58-6.97), the metabolic acidosis rate (OR=2.84, 95%CI 1.64-4.91), the cerebral hematoma rate (OR=4.17, 95%CI 2.39-7.27), the low birth weight rate (OR=3.31, 95%CI: 1.97-5.55), the rate of weight loss after birth (OR=1.08, 95%CI 1.03-1.13), the lack of breast milk rate (OR=3.90, 95%CI 1.97-7.74), and the non-hospital birth rate (OR=2.59, 95%CI: 1.93-3.45) of the neonates were the risk factors for their ABE occurrence. Conclusion: The 15 factors based on this meta-analysis are the risk factors of the neonatal ABE occurrence. However, more prospective studies with large samples, multiple centers, and accuracy are still needed to conduct for further verifying these risk factors of the neonatal ABE occurrence.
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