Affiliations: Maternity and Perinatal Care Center, Nagoya University
Hospital, Nagoya, Japan | Department of Pediatrics, Graduate School of Medicine,
Nagoya University, Nagoya, Japan | Department of Pediatric Surgery, Graduate School of
Medicine, Nagoya University, Nagoya, Japan | Department of Pediatrics, Anjo Kousei Hospital, Anjo,
Japan
Abstract: Objective: The development of cholestatic jaundice is a
well-recognized complication of parenteral nutrition (PN). The etiology of
PN-associated cholestasis (PNAC) has not been fully established. The aim of
this study was to identify the risk factors for PNAC in newborn infants. Methods: Patients who received PN containing amino acids for more than a week
were enrolled. The roles of gestational age, small for gestational age, sex,
surgery, sepsis, days of starting enteral feeding (EF), days until EF more than
100 mL/kg per day was attained, and composition of PN in the development of
PNAC were evaluated by multiple logistic regression analysis. Results: Fifty-eight infants were exposed to PN for more than a week during the study
period. Cholestasis developed in 12 of 58 subjects after the start of PN. Male
gender was associated significantly with a higher incidence of cholestasis
compared with female gender (83.3% vs 45.7%, respectively). Other
confounding factors did not correlate significantly with the development of
cholestasis. Multiple logistic regression analysis revealed that male gender
was the only independent factor (odds ratio, 8.2; 95% CI, 1.4–47.0)
associated with cholestasis. Conclusions: Male infants had a
significantly higher risk of development of PN-associated cholestasis compared
with female infants.
Keywords: Cholestasis, newborn, parenteral nutrition, risk factors, sex
