Influential factors of parenteral nutrition-associated cholestasis in extremely premature infants
10.3760/cma.j.issn.1673-4912.2025.03.009
- VernacularTitle:超早产儿肠外营养相关性胆汁淤积症的影响因素
- Author:
Caiyan MA
1
;
Linlin LI
1
;
Haixia LI
1
;
Yafen LI
1
Author Information
1. 山西省儿童医院新生儿重症监护室，太原 030000
- Publication Type:Journal Article
- Keywords:
Extremely premature infants;
Parenteral nutrition-associated cholestasis;
Influencing factors
- From:
Chinese Pediatric Emergency Medicine
2025;32(3):207-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the potential influencing factors of parenteral nutrition-associated cholestasis（PNAC）in extremely premature infants.Methods:A total of 83 cases of extremely premature infants who received parenteral nutrition and developed PNAC admitted to Shanxi Children's Hospital between October 2020 and October 2023 were selected as the case group，while 99 extremely premature infants who received parenteral nutrition but did not develop PNAC during the same period were selected as the control group. Basic information such as gender，gestational age，birth weight，and duration of parenteral nutrition were collected for the extremely premature infants. The health status of the infants at 1 minute and 5 minutes after birth was assessed using the Apgar standardized scoring method. One week after parenteral nutrition,platelet count(PLC)，mean platelet volume(MPV)，and platelet volume distribution width(PDW) were measured. Univariate analysis and non-conditional Logistic regression were used to analyze the potential influencing factors of PNAC in extremely premature infants after parenteral nutrition. Receiver operating characteristic(ROC) curves were plotted to evaluate the performance of the influencing factors and combined predictive factors in predicting PNAC in extremely premature infants receiving parenteral nutrition.Results:The 1-min and 5-min Apgar scores in the case group were lower than those in the control group( P<0.001);the percentages of gestational hypertension in mothers and postnatal infections in children were higher than those in the control group( P<0.05);and the duration of parenteral nutrition was longer than that in the control group( t=4.655, P<0.001), the differences were statistically significant. In the case group, after one week of parenteral nutrition,PLC was lower than that in the control group( t=4.949, P<0.001),MPV was higher than that in the control group( t=12.193, P<0.001), and PDW was higher than that in the control group( t=10.744, P<0.001), the differences were statistically significant.Multifactorial Logistic analysis showed that after adjusting for gender and gestational age，1-minute Apgar score（ OR=0.898），5-minute Apgar score（ OR=0.900），postnatal infection（ OR=1.256），duration of parenteral nutrition（ OR=1.426），one week after parenteral nutrition，PLC（ OR=0.902），MPV（ OR=1.441），and PDW（ OR=1.195）were independent influencing factors for PNAC in extremely premature infants（all P<0.05）. ROC curves showed that each factor and combined predictive factors had certain efficacy in predicting the occurrence of PNAC in extremely premature infants after parenteral nutrition. Conclusion:One-minute Apgar score,5-minute Apgar score，duration of parenteral nutrition，postnatal infection，one week after parenteral nutrition，the PLC,MPV and PDW are independent influencing factors for PNAC in extremely premature infants receiving parenteral nutrition.Each factor predicts the efficacy of parenteral nutrition for PNAC in extremely premature infants, and relevant factors should be controlled in time to reduce the incidence of PNAC in extremely premature infants.
