Analysis of factors affecting the prognosis of neonatal cholestasis

This study aims to analyse the risk factors affecting prognosis of cholestasis in newborns. A four-year prospective cohort study was carried out. Neonates with cholestasis were enrolled. The diagnosis of neonatal cholestasis was based on jaundice in the newborn period, direct bilirubin > 2 mg/dl, discoloured stool and elevated liver enzymes. Liver function tests were consecutively monitored weekly during the first month and then monthly until the disease was under control. All cases received oral ursodeoxycholic acid and internal medicine comprehensive treatment. No invalid case was recorded. According to the efficacy of the treatment, all cases were divided into two groups: cure group (group A; n = 69) and improved group (group B; n = 5). The clinical data of the two groups were compared. Selected patient factors were analysed to determine the risk factors affecting the prognosis of cholestasis in newborns. The serum total bilirubin and direct bilirubin levels in group B were significantly higher than those in group A (P < 0.05). A strong linear correlation was detected between the level of direct bilirubin (or total bile acid) and the duration of the disease (r > 0.5, P < 0.05). The curative effects on neonatal cholestasis and bacterial infection, cytomegalovirus (CMV) infection, venous nutrition (> 7 d) and preterm birth were closely related. The above factors were also independent risk factors affecting the prognosis of neonatal cholestasis. The direct bilirubin or total bile acid level was closely related to the duration of neonatal cholestasis. Bacterial infection, CMV infection, venous nutrition (> 7 d) and preterm birth were significant risk factors affecting the prognosis of neonatal cholestasis.