OBJECTIVETo investigate the high-risk factors for parenteral nutrition-associated cholestasis (PNAC), which is the most common complication of parenteral nutrition for infants, in very low birth weight infants (VLBWIs).

METHODSRetrospective analysis was performed on the clinical and laboratory data of 204 VLBWIs who received parenteral nutrition for over 2 weeks in the neonatal intensive care unit from August 2006 to December 2011. The infants'liver function was evaluated periodically before and after Parenteral nutrition. Univariate analysis and multivariate analysis were performed in the observation (PNAC) and control (without PNAC) groups.

RESULTSPNAC occurred in 46 (22.5%) of the 204 VLBWIs. Univariate analysis showed that continuous positive airway pressure (CPAP) ventilation, respiration failure, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) were significantly increased in the observation group compared with the control group. The observation group had lower birth weights, longer duration of ventilation, later breast feeding beginning, longer duration of fasting, longer duration of parenteral nutrition, and higher cumulated amino acid and lipid emulsion intake. Logistic regression analysis revealed that duration of fasting was a high-risk factor for PNAC (OR=1.115, 95%CI: 1.031-1.207).

CONCLUSIONSMany risk factors are associated with PNAC. Early enteral nutrition and short duration of parenteral nutrition are helpful in preventing the incidence of PNAC in VLBWIs.