ارتباط اکسی توسین و پرومتازین تزریقی هنگام زایمان با هیپربیلی روبینمی روز سوم بعد از تولد

Background and Aim: Oxytocin causes restriction of water in newborns' red blood cells because of its hyposmotic potential. Therefore red blood cells' ability to change their form decreases, but their lysis increases when they pass through reticuloendothelial system which causes hyperbilirubinemia in the newborn. Promethazin, because of its efficacy against liver bile ducts, also causes reversible hyperbilirubinemia during the first days after birth. The aim of this study was to determine the relationship between injectional oxytocin and promethazin in labor with hyperbilirubinemia on the third day after birth. Materials and Methods: This cross sectional study was carried out in 2001 on all term newborns, during a definite month in Ghods hospital,affiliated to Arak University of Medical Sciences. The newborns were selected through simple sampling. Mothers' demographic characteristics, dosage of injectional oxytocin and promethazin during labor, time of birth, sex and birth weight of the newborns , first and fifth minute Apgar score, umbilical cord hemoglobin and indirect bilirubin, time of the first feeding of the newborn, feeding type (breast- feeding, bottle-feeding ,or sweet water), number of feeding during the first 72 hours, time of meconium defecation and serum indirect bilirubin 48 to 72 hours after birth, were all recorded in a check list. The obtained data was statistically analysed applying SPSS software, statistical Z and Chi-square tests at the significant level P≤0.05. Results: On the whole, 85 newborns were evaluated in this study. There was no relationship between third day indirect hyperbilirubinemia and injections of oxytocin and promethazin during labor (P>0.05), although there was a reverse correlation with the number of breast-feeding during 24 hours (P<0.01), and a direct relationship with sweet water feeding during 24 hours (P<0.05). Linear regression modeling showed that indirect bilirubin reduced to 0.98 mg/dL on the third day after birth with every breast-feeding during 24 hours. Indirect bilirubin raised to 1.16 mg/dL per every feeding with sweet water during the same length of time. Conclusion: Based on the findings of this study, if term newborns are only breast fed during the first days after birth, the risk of indirect hyperbilirubinemia will decrease even if there were injections of oxytocin and promethazin during labor.