Male gender is related to the development of parenteral nutrition-associated cholestasis in neonates

Abstract

Objective: The development of cholestatic jaundice is a well-recognized complication of parenteral nutrition (PN). The etiology of PN-associated cholestasis (PNAC) has not been fully established. The aim of this study was to identify the risk factors for PNAC in newborn infants. Methods: Patients who received PN containing amino acids for more than a week were enrolled. The roles of gestational age, small for gestational age, sex, surgery, sepsis, days of starting enteral feeding (EF), days until EF more than 100 mL/kg per day was attained, and composition of PN in the development of PNAC were evaluated by multiple logistic regression analysis. Results: Fifty-eight infants were exposed to PN for more than a week during the study period. Cholestasis developed in 12 of 58 subjects after the start of PN. Male gender was associated significantly with a higher incidence of cholestasis compared with female gender (83.3% vs 45.7%, respectively). Other confounding factors did not correlate significantly with the development of cholestasis. Multiple logistic regression analysis revealed that male gender was the only independent factor (odds ratio, 8.2; 95% CI, 1.4-47.0) associated with cholestasis. Conclusions: Male infants had a significantly higher risk of development of PN-associated cholestasis compared with female infants.