Abstract：
UNASSIGNED: Reference guidelines for neonatal conjugated hyperbilirubinemia (cholestasis) management use a uniform approach regardless of gestational age (GA). We hypothesize that the clinical pattern of neonatal cholestasis is tightly related to GA. The aim of this study was to describe the effects of GA on neonatal cholestasis.
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.
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.
摘要：
背景：新生儿结合型高胆红素血症（胆汁淤积）治疗参考指南采用统一的方法，不考虑孕龄（GA）。我们假设新生儿胆汁淤积的临床模式与GA密切相关。这项研究的目的是描述GA对新生儿胆汁淤积的影响。
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。
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。
