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Preterm small for gestational age infants are not at higher risk for parenteral nutrition-associated cholestasis

Simonetta Costa1, Luca Maggio, Paola Sindico

  • 1Division of Neonatology, Department of Paediatrics, Catholic University Sacred Heart, Rome, Italy. simocosta@yahoo.it

The Journal of Pediatrics
|December 29, 2009
PubMed

Insights

Small for gestational age (SGA) infants are not at higher risk for parenteral nutrition-associated cholestasis (PNAC). Enteral feeding is the primary factor in preventing PNAC in very low-birth weight infants.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Parenteral nutrition-associated cholestasis (PNAC) is a significant complication in very low-birth weight (VLBW) infants requiring prolonged nutritional support.
  • The impact of being small for gestational age (SGA) on PNAC development is not well-established.

Purpose of the Study:

  • To investigate whether infants born small for gestational age have an increased risk of developing parenteral nutrition-associated cholestasis.
  • To identify key factors influencing PNAC development in VLBW infants.

Main Methods:

  • Retrospective review of VLBW infants (1996-2006) receiving parenteral nutrition for over 14 days.
  • Comparison of auxological, clinical, and nutritional data between infants with and without PNAC during the first four weeks of life.

Main Results:

  • Of 445 VLBW infants, 55 developed PNAC. Infants with PNAC had lower birth weight and gestational age but similar birth weight z-scores compared to controls.
  • PNAC infants received less enteral feeds and more intravenous glucose, lipids, and proteins, with more fasting days.
  • Reduced enteral intake and oxygen therapy were independent predictors of PNAC.

Conclusions:

  • Enteral feeding is the most crucial factor for preventing PNAC in VLBW infants.
  • Infants born small for gestational age do not exhibit a higher risk for developing PNAC.
Abstract

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