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Article type: Research Article
Authors: Takemoto, Koji; | Nakayama, Atsushi | Ito, Masatoki | Sato, Yoshiaki | Saito, Akiko | Torii, Yuka | Kaneko, Ken-ichiro | Ando, Hisami | Hayakawa, Masahiro
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
Note: [] Corresponding author: Koji Takemoto, Anjo Kousei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, 446-8602 Japan. Tel.: +1 81 0566 75 2111; Fax: +1 81 0566 76 4335; E-mail: takemoto@kosei.anjo.aichi.jp
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
DOI: 10.3233/NPM-2009-0077
Journal: Journal of Neonatal-Perinatal Medicine, vol. 2, no. 4, pp. 247-251, 2009
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