Analysis Of Influencing Factors Of Cholestasis In Late Preterm And Term Infants

Objective:Through the retrospective analysis of the clinical data of late preterm and term infants with cholestasis in our hospital in recent 5 years,the incidence of different etiologies in late preterm and term infants with cholestasis was determined,and its influencing factors were discussed,so as to guide the clinical early prevention,reduce the incidence of late preterm and term infants with cholestasis,and improve the prognosis.Methods:Late preterm infants and term infants who were hospitalized in the Department of Neonatology of the first hospital of Jilin University from January 1,2017 to December 31,2021 and whose gestational age was greater than or equal to 34 weeks were selected as the case group.At the same time,non cholestatic children with the same gestational age and meeting the inclusion and exclusion criteria were randomly selected as the control group according to 1:1.The clinical factors,blood routine examination,liver function and other laboratory indexes related to neonatal cholestasis were retrospectively analyzed.The influencing factors of neonatal cholestasis were analyzed by spss25.0 software,and the ROC curve was established.Results:1、The data showed that 247 cases of late preterm and full-term cholestasis accounted for 1.16% of the total hospitalized patients,including obstructive 12.15%,endocrine 0.81%,genetic metabolic 0.81%,neoplastic 0.40% and infectious 38.06%.Therefore,infection is an important cause of late preterm and full-term cholestasis.2、Univariate analysis: age,sex,duration of jaundice,parenteral nutrition time,first defecation time and abnormal character,infectious diseases,neonatal hypoglycemia,neonatal hemolytic disease,neonatal intracranial hemorrhage,neonatal asphyxia,patent ductus arteriosus,neonatal necrotizing enterocolitis,total white blood cells,percentage of neutrophils,percentage of lymphocytes,total red blood cells,hemoglobin Aspartate aminotransferase,alanine aminotransferase γ-There were significant differences in glutamyl transpeptidase,alkaline phosphatase,albumin,total bile acid and lactic acid.（p<0.05）3 、 Multivariate analysis: parenteral nutrition time（or=1.161,95%ci:1.072-1.258）,infectious diseases（or=20.875,95%ci:7.061-61.721）,total bile acid（or=1.115,95%ci:1.078-1.153）were independent risk factors for cholestasis in late preterm and term infants;Percentage of lymphocytes（or=0.013,95%ci:0.001-0.299）,hemoglobin（or=0.966,95%ci:0.953-0.979）,albumin（or=0.866,95%ci:0.781-0.962）were protective factors for cholestasis in late preterm and term infants.4 、 According to the ROC curve established by the logistic regression equation obtained in this study,the area under the curve is 0.969,which is statistically significant.（p<0.05）Conclusions:1.Infection is an important cause of cholestasis in late preterm and term infants.2.Parenteral nutrition time,infectious diseases and total bile acid level are independent risk factors for cholestasis in late preterm and term infants.Lymphocyte percentage,hemoglobin and albumin were protective factors.