Factores de riesgo maternos y perinatales para hiperbilirrubinemia neonatal severa. Hospital de Sullana 2015-2019

Abstract

Objetivo: Determinar los factores maternos y perinatales asociados a hiperbilirrubinemia neonatal severa en el Hospital de Sullana; 2015-2019. Material y métodos: Se realizo un estudio de tipo observacional, analítico de caso-control. La población fueron los neonatos a término con diagnóstico de hiperbilirrubinemia neonatal del Hospital de Sullana desde el 2015 a 2019. La muestra estuvo conformada por 204 neonatos, 68 son los casos y 136 los controles. Análisis estadístico: Se aplicó la prueba de Chi cuadrado y se calculó la Odd Ratio (OR), para determinar si estos factores maternos y perinatales son o no de riesgo para hiperbilirrubinemia severa, considerando una significancia del 5%. Resultados: La edad promedio de las madres fue 26.1±6.6 años, el 70.1% se realizó de 6 a más controles prenatales, el 39.2% se utilizó oxitocina, Apgar a los 5 minutos y el peso al nacer promedio de los recién nacidos fueron 9.4±0.6 y 3329.9±437.5 g, respectivamente. De los recién nacidos el 54,4% fueron mujeres, pertenecían al grupo sanguíneo fetal O (39.7%), presentaban Rh fetal + (99%), presentaron ictericia dentro de las primeras 24 horas (12.7.%), perdida de peso (67.6%) y evidenciaron lactancia materna inadecuada (68.1%). La edad menor a 20 años (p=0.015; OR=2.315; IC95%= 1.164-4.606), la pérdida patológica de peso (p<0.001; OR=18.699; IC95%= 5.601-62.423) y la lactancia materna inadecuada (p<0.001; OR=18.153; IC95%= 5.437-60.609) fueron factores de riesgo para hiperbilirrubinemia severa. Conclusión: La edad materna menor a 20, la pérdida patológica de peso y la lactancia materna inadecuada fueron factores maternos y patológicos de riesgo para hiperbilirrubinemia severa.

Objective: To determine the maternal and perinatal factors associated with severe neonatal hyperbilirubinemia at the Hospital de Sullana; 2015-2019. Methodology: An observational, analytical case-control study was carried out. The population was full-term neonates diagnosed with neonatal hyperbilirubinemia at Sullana Hospital from 2015 to 2019. The sample consisted of 204 newborns, 68 were cases and 136 were controls. Statistical analysis: The Chi square test was applied and the Odd Ratio (OR) was calculated to determine whether or not these maternal and perinatal factors are risk for severe hyperbilirubinemia, considering a significance of 5%. Results: The average age of the mothers was 26.1 ± 6.6 years, 70.1% underwent 6 or more prenatal check-ups, 39.2% used oxytocin, Apgar at 5 minutes and the average birth weight of the newborns was 9.4 ± 0.6 and 3329.9 ± 437.5 g, respectively. Of the newborns, 54.4% were women, belonged to fetal blood group O (39.7%), had fetal Rh + (99%), had jaundice within the first 24 hours (12.7%), weight loss (67.6 %) and showed inadequate breastfeeding (68.1%). Age younger than 20 years (p = 0.015; OR = 2.315; 95% CI = 1.164-4.606), pathological weight loss (p <0.001; OR = 18.699; 95% CI = 5.601-62.423) and inadequate breastfeeding (p <0.001; OR = 18.153; 95% CI = 5.437-60.609) were risk factors for severe hyperbilirubinemia. Conclusion: Maternal age less than 20, pathological weight loss, and inadequate breastfeeding were maternal and pathological risk factors for severe hyperbilirubinemia.