Risk factors of parenteral nutrition‐associated cholestasis in very‐low‐birthweight infants. (26th February 2020)

• Record Type: Journal Article
• Authors: Wang, Nan; Yan, Weihui; Hong, Li; Lu, Lina; Feng, Yi; Wu, Jiang; Tao, Yijing; Ruan, Huijuan; Tang, Qingya; Cai, Wei; Wang, Ying
• Is Part Of: Journal of paediatrics and child health. Volume 56:Number 11(2020)
• Page Start: 1785
• Page End: 1790
• Publication Date: 2020-02-26
• Subjects: parenteral nutrition -- parenteral nutrition‐associated cholestasis -- risk factor -- very‐low‐birthweight infant; Children -- Health and hygiene -- Periodicals; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/jpc.14826
• Languages: English
• ISSNs: 1034-4810

Abstract

Abstract : Aim: We aimed to explore risk factors associated with parenteral nutrition‐associated cholestasis (PNAC) in very‐low‐birthweight (VLBW) infants. Methods: VLBW infants receiving parenteral nutrition (PN) for at least 14 days were enrolled in a retrospective dual‐centre study and divided into two groups chronologically: group A (2000–2007) and group B (2008–2015). The incidence of PNAC and related factors were investigated. We compared the differences between PNAC and non‐PNAC groups. A multivariate binary logistic regression analysis was carried out to identify the potential risk factors of PNAC. Results: A total of 387 VLBW infants (53 in group A and 334 in group B) were enrolled in the study. The total incidence of PNAC was 6.7%, 9.4% in group A and 6.3% in group B. The dosage of amino acid ( P = 0.009), glucose ( P = 0.006), PN calories ( P = 0.021) and the ratio of glucose/fat ( P = 0.014) were significantly higher in group B than in group A. Non‐protein energy to nitrogen ratio ( P = 0.017) was lower in group B. Birthweight was significantly lower in the PNAC group than in the non‐PNAC group ( P = 0.021). Subgroup analysis showed that gestational age and duration of PN were significantly different between the PNAC and non‐PNAC groups ( P < 0.05). Logistic regression showed that prolonged duration of PN (≥43 days) (odds ratio 3.155, 95% confidence interval 1.009–9.861, P = 0.048) was an independent risk factor of PNAC. Conclusions: For VLBW infants, prolonged duration of PN is a risk factor for the development of PNAC. PNAC may be prevented by weaning off PN as early as possible in VLBW infants.