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Copper Supplementation in Premature Infants With Parenteral Nutrition-Associated Cholestasis

Kunal Gupta1, Hongyue Wang2, Sanjiv B Amin3

  • 1Division of Neonatology, Department of Pediatrics, Hennepin County Medical Center, Minneapolis, Minnesota, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|March 13, 2018
PubMed

Insights

Intermittent parenteral copper supplementation (IPC) did not affect serum copper levels or indicators of toxicity/deficiency in premature infants with parenteral nutrition-associated cholestasis (PNAC). Copper status is primarily influenced by prematurity and postmenstrual age.

Area of Science:

  • Neonatology
  • Nutritional Science
  • Pediatric Gastroenterology

Background:

  • Parenteral nutrition-associated cholestasis (PNAC) is a complication in premature infants.
  • Copper is essential but can be toxic; its role in PNAC requires clarification.
  • Intermittent parenteral copper supplementation (IPC) is used, but its impact on copper status in PNAC is unknown.

Purpose of the Study:

  • To assess the effect of IPC on serum copper status in premature infants with PNAC.
  • To evaluate IPC's association with biochemical and hematological markers of copper toxicity and deficiency.
  • To identify factors influencing copper status in this vulnerable population.

Main Methods:

  • Prospective observational study of 24 premature infants with PNAC receiving IPC.
  • Exclusion of infants with specific genetic, infectious, or surgical conditions.
  • Regular monitoring of serum copper, liver enzymes, and hematological parameters.

Main Results:

  • IPC showed no significant association with serum copper concentration after controlling for gestational age (GA) and baseline intake.
  • IPC was not linked to markers of hepatotoxicity (ALT, AST) or copper deficiency (platelets, Hct, WBC, neutrophils).
  • GA and postmenstrual age were independently associated with serum copper levels.

Conclusions:

  • IPC does not appear to alter copper status in premature infants with PNAC.
  • Copper status in these infants is primarily determined by prematurity and postmenstrual age.
  • Further research may be needed to optimize copper management in PNAC.

Keywords:
cholestasiscoppercopper deficiencycopper toxicityhepatotoxicityinfantnutritional supportparenteral nutrition

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