Influencing Factors And Outcome Of Cholestasis In Preterm Infants

Objective: To investigate the clinical features and outcome of cholestasis in preterm infants.Methods: The clinical data of premature infants(case group)admitted to the second neonatal department of shengjing hospital affiliated to China medical university and diagnosed with cholestasis from January 2016 to December 2018 were retrospectively analyzed.Non-cholestatic preterm infants who were hospitalized at the same time,with the same number,gestational age and birth weight were randomly selected as the control group.The clinical data of the two groups were compared to understand the clinical features and risk factors of premature infant cholestasis,and to explore its influence on premature infants.Results: All cases were 112,male/female 2.02/1;GA25-36 w,average(M,IQR)30(28,31)w,GA<32w accounted for 78%.BW 440-3840 g,average(M,IQR)1142(979,1300)g,and those with BW<1500g accounted for 83%.Median daily age(M,IQR)35(27,44)d and median postmenstrual age(M,IQR)36(33,37)w when cholestasis occurred.Compared with the control group,the duration of parenteral nutrition(37(28,48)d vs.23(17,33)d,p=0.00)and the length of hospital stay(62(47,77)d vs.45(28,65)d,p=0.00)in the case group were longer.Starting enteral feeding time(5(3,8)d vs.4(2,6)d,p=0.02)and reaching total enteral feeding time(37(27,48)d vs.22(16,34)d,p=0.00)later;NEC(16.1% vs.4.5%,p=0.00)?PDA(15.2% vs.6.1%,p=0.03)?EUGR(91.2% vs.83.0%,P=0.01)higher percentage.The rate of weight gain(g/kg.d)slowed down after cholestasis(12.7(10.1,15.5)vs.7.6(4.5,10.0),p=0.00).Logistic regression analysis showed that long PN time was an independent risk factor for cholestasis in premature infants.Conclusion: Cholestasis in preterm infants is more common in ultrafast preterm infants and early preterm infants or in infants with extremly low or very low birth weight.The incidence of EUGR was increased with cholestasis,and the length of hospital stay was prolonged.Prolonged parenteral nutrition is an independent risk factor for cholestasis in preterm infants.