Icterícia neonatal: fatores associados à necessidade de fototerapia em alojamento conjunto

Abstract

OBJECTIVE: To investigate the frequency of neonatal jaundice and use of phototherapy. To identify risk factors associated with phototherapy in rooming-in care (RC). METHODS: Retrospective study with newborns = 35 weeks in a Tertiary Hospital RC from October to December 2017. Newborns were divided into two groups: treated and untreated for jaundice. Included: inborn neonates without congenital anomalies. Newborns who were admitted in a neonatal ward were excluded. Maternal, gestational, neonatal clinical data and care practices were evaluated. Outcome: use of phototherapy. Associations between groups were assessed using the Students t-test for continuous variables and chi-square for categorical ones. Multiple logistic regression was used to identify independent risk factors associated with phototherapy. RESULTS: 376 newborns were included. 176 newborns (47%) were diagnosed with neonatal jaundice and 66 newborns (18%) were treated with phototherapy. Treated group had lower gestational age (38 x 39 weeks), higher level of bilirubin in umbilical cord blood (2 x 1.5mg/dL), greater weight loss (7 x 6%), more frequent ABO incompatibility (35 x 10%) and prolonged length of hospital stay (79 x 50 hours). Logistic regression identified as independent risk factors for phototherapy: gestational age (OR=6); umbilical cord bilirubin (OR=16); ABO incompatibility (OR=12) and weight loss (OR=1.24). CONCLUSION: Neonatal jaundice was frequent in RC and almost 20% of the newborns were treated with phototherapy. Weight loss was the only preventable risk factor for phototherapy and no protective factor was found.