本會與國家衛生研究院及台北榮民總醫院合作分析評估「台灣新生兒黃疸個案長期神經發育預後追蹤」,成果已發表於國際期刊

由環境因素和/或藥物引發的嚴重新生兒黃疸是 G6PD 缺乏症對新生兒的主要健康影響。 如果不能正確預防或治療,可能會導致核黃疸並導致死亡或永久性神經損傷。

透過積極推動與執行公共衛生預防計劃 (如全國性新生兒 G6PD 篩檢與家長衛教等)、以及臨床醫生對新生兒黃疸意識提高,和有效積極的治療管理皆有助於減少這些急性嚴重後遺症發生,研究發現台灣幾乎完全消除了黃疸對新生兒的嚴重危害。但是新生兒黃疸對嬰幼兒的長期發展仍有嚴重的影響。

因此本會特與國家衛生研究院江博煌博士及台北榮民總醫院小兒部曹珮真醫師合作,利用全民健保資料庫分析評估台灣新生兒黃疸個案的長期神經發育後遺症發生情形及預後,並撰寫論文「Long-term neurodevelopmental outcomes of significant neonatal jaundice in Taiwan from 2000–2003: a nationwide, population-based cohort study」獲國際知名的科學期刊 Scientific Report 接受,於 2020年 7 月發表。

本會蕭廣仁執行長 ( Hsiao KJ ) 為本文通訊作者。

專案經理蕭郁詩 ( Shiau YS ) 與執行秘書蔣思慧 ( Chiang SH )為本文第一共同作者及第三作者。

Tsao PC., Yeh HL., Shiau YS, Chang YC, Chiang SH, Soong WJ, Jeng MJ, Hsiao KJ, Chiang PH. Long-term neurodevelopmental outcomes of significant neonatal jaundice in Taiwan from 2000–2003: a nationwide, population-based cohort study. Sci Rep 10, 11374 (2020). https://doi.org/10.1038/s41598-020-68186-w

新生兒黃疸(Neonatal Jaundice)可能是一種良性生理過程,也可能是神經系統中表現出膽紅素相關毒性的嚴重疾病的第一個徵兆。雖然新生兒黃疸的新生兒可能因膽紅素數值高,而可較早接受醫療評估及治療干預,但新生兒黃疸對該族群造成的後續神經功能障礙影響可能被低估。

為了瞭解台灣新生兒黃疸個案長期神經功能障礙的發生情形,本研究利用全民健保資料庫 2000 年到 2010 年的數據進行世代研究分析(Cohort Study),調查2000 ~ 2003年出生的新生兒黃疸個案至7歲的神經發育後遺症累積發生率。研究結果發現新生兒黃疸個案的長期神經發育後遺症累積發生率顯著高於對照族群(P <0.05)。新生兒黃疸對嬰幼兒的長期 ( 7 年 ) 發展還是有嚴重的影響,需要常規細心的追蹤,以利早期發現早期介入。

 


ABSTRACT

We aimed to investigate the risk of long-term neurodevelopmental sequelae of SNJ in Taiwan. An SNJ 2000–2003 follow-up cohort consisting of 66,983 neonates was extracted from the nationwide, population-based health insurance database in Taiwan to survey the accumulative incidence of long-term (7-year) neurodevelopmental sequelae in comparison to a reference general-population neonate cohort of 12,579 individuals born in 2000. The SNJ follow-up cohort was furtherly categorized into subgroups according to interventions (phototherapy, intensive phototherapy, and exchange transfusion). The SNJ follow-up cohort exhibited significantly higher cumulative rates of long-term neurodevelopmental sequelae than did the reference cohort (P < 0.05). The risks of infantile cerebral palsy, hearing loss, and developmental delay in the SNJ follow-up cohort were between twice and three times of those in the reference cohort after adjusting for gender, comorbid perinatal disorders and urbanization levels. All intervention subgroups demonstrated higher risks for long-term neurodevelopmental sequelae than the reference cohort (P < 0.05) after adjustment.
Patients with SNJ are at risk of developing neurodevelopmental disorders during their growth period. A scheduled follow-up protocol of physical and neurodevelopmental assessment during early childhood for these SNJ patients would potentially be helpful for the early detection of and intervention for neurodevelopmental disorders.