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Postnatal physiologic hypercholemia in both premature and full-term infants

S Barnes, G Berkowitz, B I Hirschowitz

    The Journal of Clinical Investigation
    |September 1, 1981
    PubMed

    Insights

    Newborn infants experience a physiological increase in serum bile salt concentrations within their first week of life, regardless of health or gestational age. This hypercholemia has implications for liver function and substance metabolism in neonates.

    Area of Science:

    • Neonatal physiology
    • Bile salt metabolism
    • Hepatology

    Background:

    • Previous research indicated adult-like bile salt levels in term infants at birth.
    • Understanding neonatal bile salt homeostasis is crucial for infant health.

    Purpose of the Study:

    • To quantify serum bile salt concentrations in premature and term infants.
    • To investigate the changes in bile salt levels during the first week postpartum.

    Main Methods:

    • Utilized 125I-radioimmunoassay and capillary gas liquid chromatography-mass spectrometry.
    • Measured serum bile salt concentrations in premature and term infants at birth and during the first week of life.

    Main Results:

    • Infant serum bile salt concentrations at birth were similar to adult levels.
    • A four- to sevenfold increase in serum bile salt concentration was observed in both infant groups within the first week postpartum.
    • This increase was independent of gestational age and infant health status.

    Conclusions:

    • Hypercholemia is a normal physiological state in newborn infants.
    • Elevated bile salt levels in neonates impact the metabolism and excretion of substances dependent on bile salt secretion.
    • Caution is advised when considering parenteral nutrition's role in neonatal cholestasis.

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