UNASSIGNED: A retrospective 4-year cohort study in a 70-bed neonatal care unit. Neonates with conjugated bilirubin≥34.2μmol/L (2 mg/dL) were identified. The incidence, clinical characteristics, etiology, treatment, and prognosis were compared between infants <32 and≥32 weeks GA.
UNASSIGNED: Overall incidence of cholestasis was 4% (125/3402). It was >5 times higher and the mean duration was >1.5 times longer in neonates <32 weeks GA (10% versus 1.8%, p <0.01 and 49 versus 31 days, p <0.01, respectively). The onset of cholestasis was later in neonates <32 weeks (22 versus 10 days of life, p <0.001). This later onset of cholestasis was associated with parenteral nutrition, whereas the earlier onset was associated with other causes. Treatment using fish oil lipids was more frequently administrated to infants <32 weeks GA, whereas Ursodeoxycholic acid was administrated more frequently in≥32 weeks GA. Cholestasis resolved during hospitalization in 73% of <32 versus 38% in≥32 weeks GA infants (p <0.01).
UNASSIGNED: The incidence, clinical presentation, etiology, treatment, and clinical evolution of neonatal cholestasis were all significantly affected by GA. Our results support the use of a GA-oriented approach for the management of neonatal cholestasis.
方法:一项在70张病床的新生儿监护病房进行的为期4年的回顾性队列研究。确定结合胆红素≥34.2μmol/L(2mg/dL)的新生儿。发病率,临床特征,病因学,治疗,比较<32周和≥32周GA婴儿的预后。
结果:胆汁淤积的总发生率为4%(125/3402)。>5倍以上,平均持续时间>1.5倍以上新生儿<32周GA(10%对1.8%,p<0.01和49天对31天,p分别<0.01)。在<32周的新生儿中,胆汁淤积的发作较晚(22对10天的生命,p<0.001)。胆汁淤积的晚期发作与肠外营养有关,而较早的发病与其他原因有关。使用鱼油脂质的治疗更频繁地给予<32周GA的婴儿,而熊去氧胆酸在≥32周时给药频率更高。在住院期间,<32周龄的婴儿中,有73%的胆汁淤积消退,而≥32周龄的婴儿中,有38%的胆汁淤积消退(p<0.01)。
结论:发病率,临床表现,病因学,治疗,新生儿胆汁淤积的临床演变均显著受孕龄影响。我们的结果支持使用面向GA的方法来管理新生儿胆汁淤积。