Restrospective analysis of clinicopathological features of 128 cases of neonatal cholestasis

Abstract

Objective To summarize the clinical data of neonatal cholestasis and analyze its difference between premature and full-term infants. Methods A total of 128 cases of neonatal cholestasis were retrospectively analyzed from February 2017 to February 2019 at the Department of Neonatology of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics. The patients were divided into a full-term infant group (66 cases) and premature infant group (62 cases) according to their gestational weeks. The general clinical data, biochemical indicators, and ultrasonographic results of the two groups were compared. The age, duration of jaundice, and the levels of aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), albumin, globulin, serum Ca2+, bile acid, blood ammonia, lactic acid, and alkaline phosphatase (ALP) were compared by the t-test. The levels of gamma-glutamyl transpeptidase (GGT) and alanine aminotransferase (ALT) in the two groups were compared by the Mann-Whitney U rank sum test. The Chi-square test was used to compare the sex ratio, the incidence of clay stool, hepatomegaly, and splenomegaly, and the percentages of patients with GGT level>300 U/L, TBil concentration>150.0 mol/L, and DBil concentration>100.0 mol/L in the two groups. Results There was no significant difference in age, the duration time of jaundice or the incidence of hepatomegaly and splenomegaly between the two groups (P>0.05), but there was a significant difference in the onset time of jaundice (P 300 U/L, TBil >150.0 mol/L, DBil>100.0 mol/L, and biliary atresia were significantly higher in the full-term infant group than in the preterm group (χ2=17.266, 34.613, 26.848, 18.657, and 35.186, P<0.05). The GGT level and DBIL concentration of full-term infants were 389.9 U/L (316.0-1127.3) and (118.3±35.2) mol/L, respectively, which were significantly higher than those of preterm infants [128.9 (110.3-361.8) and (86.3±35.8) mol/L; Z=2.845, P=0.003; t=3.314, P<0.05]. Conclusion Biliary cholestasis in full-term infants is different from that in premature infants. The incidence of biliary atresia in full-term infants is higher. Cholangiography should be performed actively to exclude biliary atresia. Key words: Full-term infants; Premature infant; Newborn; Neonatal cholestasis; Biliary atresia