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Published on: June 5, 2014

Parenteral nutrition-associated cholestasis in preterm neonates: evaluation of ursodeoxycholic acid treatment

A Levine1, A Maayan, R Shamir

  • 1Division of Gastroenterology and Nutrition, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|July 27, 1999
PubMed

Insights

Ursodeoxycholic acid (UDCA) is safe for premature infants with parenteral nutrition-associated cholestasis, showing early bilirubin decreases. However, transaminase improvements were not sustained in this small study.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Hepatology

Background:

  • Parenteral nutrition (PN) is crucial for premature infants but can cause cholestatic liver disease.
  • Ursodeoxycholic acid (UDCA) is a potential treatment for PN-associated cholestasis in various age groups.

Purpose of the Study:

  • To evaluate the efficacy of ursodeoxycholic acid (UDCA) in premature infants experiencing parenteral nutrition-associated cholestasis.

Main Methods:

  • Retrospective chart review of infants treated with UDCA for PN-associated cholestasis.
  • Assessment of bilirubin, ALT, AST, and ALP levels over at least one month of treatment.

Main Results:

  • Six infants received UDCA (15-30 mg/kg/day); cholestasis onset averaged 47 days after 42 days of PN.
  • Bilirubin levels decreased in all infants; transaminases showed mixed responses.
  • No toxicity was observed; bilirubin improvement correlated with enteral nutrition initiation.

Conclusions:

  • UDCA appears safe in premature infants with PN-associated cholestasis.
  • UDCA led to an early, sustained decrease in bilirubin levels within two weeks.
  • Transaminase response was inconsistent and not sustained in this limited cohort.
Abstract

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