OBJECTIVETo investigate risk factors for parenteral nutrition-associated cholestasis (PNAC) in preterm infants.

METHODSA retrospective case-control study was performed on 244 preterm infants who received parenteral nutrition (PN) for over 14 days from January 2000 to October 2011.

RESULTSCompared with those without PNAC (n=221), preterm infants with PNAC (n=23) had a longer total duration of PN, a higher total amino acid intake, a higher total lipid intake, a higher maximum daily amino acid intake, a higher maximum daily lipid intake, a higher intravenous calorie intake on the 14th day of PN, a lower birth weight and higher incidence rates of neonatal infection and anemia. Compared with those with PNAC, preterm infants without PNAC who showed a higher total amino acid intake also had a higher total lipid intake, a longer total duration of PN, a higher rate of mechanical ventilation and a lower gestational age. The preterm infants without PNAC who showed a higher total lipid intake also had a lower gestational age. Preterm infants without PNAC who showed a longer total duration of PN also had a lower gestational age.

CONCLUSIONSTotal duration of PN, total amino acid intake, maximum daily amino acid intake, total lipid intake, maximum daily lipid intake, intravenous calorie intake on the 14th day of PN, low birth weight, and neonatal infection and anemia are the risk factors for PNAC. Other risk factors need further investigation.