Risk factors of parenteral nutrition‐associated cholestasis in very‐low‐birthweight infants
First published:26 February 2020
Nan Wang and Weihui Yan contributed equally to this work and share the first authorship.
Conflict of interest: None declared.
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.
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