Prolonged Jaundice Research Articles

Do Gene Polymorphisms Play a Role in Newborn Hyperbilirubinemia?

Polymorphisms of the uridine-diphospho-glucuronosyltransferase 1A1 (UGT1A1) gene, hepatic solute carrier organic anion transporter 1B1/B3 (SLCO1B1/3) gene, and glutathione S-transferase (GST) gene have been associated with significant hyperbilirubinemia in some populations. This study aims to determine whether the variation of UGT1A1, SLCO1B1/3 and GST genes play an important role in neonatal hyperbilirubinemia in Turkish newborn infants. The study included 61 idiopathic hyperbilirubinemia cases, 28 prolonged jaundice cases, and 41 controls. Ten common polymorphisms in four genes involved in bilirubin metabolism were examined. Polymerase chain reaction-restriction fragment length polymorphism method was used to detect variants of those genes. No association was found between the variants of UGT1A1 at nt 211, the SLCO1B1 gene at nt 388, 463, 521, 1463, the SLCO1B3 gene at nt 334, 727+118, 1865+19721, and the GST gene at nt 313, 341, and neonatal hyperbilirubinemia. There was no difference between the case and control groups in terms of allele frequencies of these genes (except SLCO1B3 at nt 334) (p>0.05 in all comparisons). The presence of the G allele of the SLCO1B3 at nt 334 variant gene seemed to protect from jaundice in infants with idiopathic hyperbilirubinemia. These gene polymorphisms currently studied do not seem to modulate the risk of hyperbilirubinemia in Turkish newborn infants.

The Successful Administration of Steroid in Extrahepatic Cholestasis

Biliary atresia is the most common cause of liver transplantation in children. Kasai surgery is still a bridging therapy for biliary atresia, but patients are often late for treatment. Based on the currently proposed theory, biliary atresia results from a progressive inflammatory process and progresses to fibrosis of the bile ducts. A case of a 1.5-month-old boy with prolonged jaundice followed by acholic stools and dark urine was presented. He had cholestasis, elevated GGT levels, and a liver biopsy suggesting extrahepatic cholestasis. He was treated with methylprednisolone, ursodeoxycholic acid, and vitamin supplementation was started orally. After steroid therapy, direct bilirubin levels decreased rapidly to 0.55 mg/dl on day 14. Jaundice, acholic stools, cholestasis, and liver function tests were improved. Therapeutic opportunities based on the pathogenesis of inflammation in biliary atresia using steroids may provide new opportunities for non-surgical management of biliary atresia in the early phase of the disease.

Un caso di ipopituitarismo in età infantile

Hypopituitarism is often an evolutionary condition, which if not present at birth with the classic signs of severe hypoglycaemia, prolonged jaundice, bilateral cryptorchidism and / or micropenis and alterations of neurological development, causes a delay in diagnosis with disabling consequences. The paper describes the case of a child of 3 years and 2 months presenting with poor growth and reduction of growth speed. After clinical and laboratory diagnosis, MRI imaging was performed showing the presence of congenital adenohypophyseal hypoplasia that must be followed over time for the possible development of other hormonal deficits.

Climatic factors and prolonged neonatal jaundice

Prolonged neonatal jaundice (PrNJ) in full-term newborns(NB) is defined if it persists beyond the 14th day after birth. Clinical experience shows that seasons of the year influence the frequency and severity of neonatal jaundice (NJ). Objective: To establish the role of climatic factors on PrNJ expression in term neonates. Material and methods: The study was conducted at the Neonatology Department of University Hospital "Medica Ruse" with 92 full-term newborns who were with PrNJ. The follow-up of NJ was carried out with transcutaneous bilirubinometry. The NBs are residents of Ruse region, Republic of Bulgaria. Results: We found that air temperature directly affects the levels of bilirubin(BR) for the entire neonatal period and the duration of PrNJ. The amount of rainfall during the first two weeks after birth directly correlated with bilirubinemia at end of neonatal period and the duration of PrNJ. A higher level of atmospheric pressure during the early neonatal period was associated with lower BR levels at the same and a shorter duration of PrNJ. The degree of cloudiness after postnatal day 14 is inversely related to the levels of BR and the duration of the PrNJ. Sunshine during the first two weeks affects the levels of BR on the end of neonatal perod and the prolongation of PrNJ. Conclusion: According to our data climatic factors: air temperature, amount of rainfaull, atmospheric pressure, degree of cloudiness, duration of sunshine affect the degree of manifestation and duration of PrNJ.

A Case Report on Congenital Biliary Atresia with Ventricular Septal Defect

Biliary atresia, an obstructive cholangiopathy with an idiopathic etiology, is a congenital disorder that eventually destroys liver parenchyma. In some circumstances, it is associated with other abnormalities such as congenital heart diseases, intestinal, and spleen anomalies. Diagnosis of biliary atresia is based on clinical manifestations and specific diagnostic tests. Prolonged pathological jaundice is a critically important sign in newborns that needs to be recognized early in order to reduce the chances of further complications. The mainstay of treatment is the Kasai procedure (portoenterostomy), and it is eighty percent successful if performed before or within the first two months of life.Here, we report a case of a two-month-old baby who had biliary atresia with a ventricular septal defect (VSD). The baby had a prolonged history of jaundice, pruritus, yellow-colored urine, and pale stools. He was initially brought to a local clinic for his jaundice, where pharmacological treatment was commenced. However, the symptoms persisted, and he was referred to a hospital where he was placed under blue light phototherapy with no marked improvement in his symptoms. For a definite diagnosis and treatment, he was then referred to a multispecialty hospital where diagnostic tests were ordered. The HIDA scan showed no uptake of contrast in the bile ducts and gallbladder, which is suggestive of congenital biliary atresia. An intraoperative cholangiogram showed a definite diagnosis of biliary atresia, which was performed, and the Kasai procedure was done successfully. All his family members were healthy with no history of congenital disease.The essential outcome in this case is to consider biliary atresia as a cause of prolonged jaundice in infants, and occasionally it is associated with other congenital anomalies. The diagnosis and treatment should be urgent in order to prevent complications.

An evaluation of ursodeoxycholic acid treatment in prolonged unconjugated hyperbilirubinemia due to breast milk.

Prolonged jaundice is one of the most common problems during neonatal period. The aim of this study was to evaluate the efficiency of ursodeoxycholic acid (UDCA) treatment in newborn infants with prolonged unconjugated hyperbilirubinemia. The present study included 27 patients who were fed by breast milk and followed up in the outpatient clinic due to prolonged jaundice without any underlying etiological factor; 10 mg/kg/day UDCA was administrated in two doses for 7 days. Furthermore, 20 newborns diagnosed with prolonged jaundice with same characteristics were enrolled as the control group. The control group was also given a placebo; demographic characteristics, liver functions tests before and after the treatment, bilirubin decrease rates, and hemogram parameters of groups were compared. Total bilirubin levels in the study and control groups before the treatment were 16.02 ± 1.41 mg/dL and 15.93 ± 1.66 mg/dL, respectively (P = 0.84). Total bilirubin levels in the study and control groups at day 7 after UDCA treatment were detected 8.18 ± 2.31 mg/dL and 13.92 ± 2.66 mg/dL, respectively (P < 0.001), and at day 14 after the treatment were 5.45 ± 2.59 mg/dL and 11.91 ± 2.83 mg/dL, respectively (P < 0.001). Furthermore, serum aspartate aminotransferase (AST) was detected <21 U/L in the ROC analysis after UDCA treatment (P = 0.04). The study outcomes indicated that an efficient reduction in total bilirubin levels may be achieved, and outpatient clinic follow-up period may be reduced in patients whom UDCA was administrated. Moreover, it may be speculated that AST can be used to evaluate the efficacy after treatment. However, studies with larger sample sizes are needed for the routine use of UDCA in the treatment of prolonged jaundice.

An Unusual Presentation: Prolonged Jaundice Associated with Infantile Hypertrophic Pyloric Stenosis. A Case Report

An Unusual Presentation: Prolonged Jaundice Associated with Infantile Hypertrophic Pyloric Stenosis. A Case Report

Term Yenidoğanlarda Uzamış Sarılık ile Vitamin B12 Düzeyleri Arasındaki İlişki

Abstract &#x0D; Aim: Vitamin B12 deficiency, when observed during the neonatal period, can generally be traced back to maternal causes. In cases of vitamin B12 deficiency, hyperbilirubinemia may occur due to hem overproduction as the result of erythrocyte lysis. Prolonged jaundice is common during the neonatal period, and its underlying etiological causes should be analyzed. The aim of this study was to analyze whether vitamin B12 deficiency has any effect on prolonged jaundice formation in infants. &#x0D; Material and Method: The study examined 89 infants; this included 45 that had been diagnosed with prolonged jaundice and 44 in the control group. Their clinical and demographic characteristics were recorded. Patient group was formed with term infants with prolonged jaundice excluding possible etiological causes of prolonged jaundice. Both the maternal and infant vitamin B12 levels were analyzed. &#x0D; Results:An indirect bilirubin level of 11.8 mg/dl in the prolonged jaundice group and 3.16 mg/dl (p &lt; 0.001), a hemoglobin level of 14.18 gr/dl and 15.7 gr/dl (p = 0.005), and infant vitamin B12 level of 168 pg/ml and 205.2 pg/ml (p=0.013) in the patient and control groups, respectively, showed significant differences between the two. Maternal vitamin B12 levels were found to be similar in the patient and control groups (p= 0.315), and there was no significant correlation between the vitamin B12 levels of the infants and mothers (r = 0.278, p = 0.064). &#x0D; Conclusion: Vitamin B12 deficiency can be related to prolonged jaundice in neonatals, and an early diagnosis of vitamin B12 deficiency in high risks group in the neonatal period can be useful in terms of potentially identifying and controlling related conditions.&#x0D; Keywords: Jaundice, newborn, vitamin B12 deficiency

Chinese herbs in maternal diets related to clinical presentations in breastfed infants

IntroductionFew studies explored the effects of maternal herb consumption on breastfed infants. Our aims were to investigate the relationship between maternal consumption of Chinese herb-enriched diets and clinical presentations of breastfed infants at 1 to 2 months of age. MethodsThis prospective study enroled healthy infants aged 25 to 60 days from the Taipei branch of Chang Gung Memorial Hospital in Taiwan during 2013-2019. We measured feeding type, weight gain, jaundice, stool frequency, irritability, sleeping hours, regurgitation, and flatulence. Four commonly used Chinese diets were assessed, including Eucommia ulmoides, Si-Wu-Tan, Sheng-Hua-Tang, and sesame oil chicken. ResultsWe enroled 751 infants, of whom 359 were on exclusive breastfeeding, 52 on formula feeding, and 340 on partial breastfeeding (at least one meal each of breast milk and formula daily). We observed significant differences in activity, sleeping hours, jaundice, and stool frequency between infants on exclusive breastfeeding, formula feeding, and partial breastfeeding. Regarding infants on exclusive breastfeeding, multivariate logistic regression analyses revealed that infants whose mothers consumed E ulmoides were at higher risk of prolonged jaundice. In contrast, infants whose mothers consumed Si-Wu-Tan were at lower risk of prolonged jaundice. Furthermore, stool passage frequency increased in infants whose mothers consumed E ulmoides, Si-Wu-Tang, and sesame oil chicken. ConclusionsOur results showed that maternal diets containing certain Chinese herbs, specifically E ulmoides and Si-Wu-Tan are related to breast milk jaundice, while E ulmoides, Si-Wu-Tang, and sesame oil chicken are related to increased stool frequency among breastfed infants.

A Rare Case of Cystic Biliary Atresia

Biliary atresia is one of the commonest causes of prolonged jaundice in neonate, whereas cystic biliary atresia is a rare form of biliary atresia with similar presentation, but a slightly different sonographic finding. Being able to differentiate them radiologically is important as the surgical management is different for these two diagnoses. An ultrasound examination was done for a 2-month-old baby girl with prolonged jaundice with the finding of a cyst along the portal triad, which raised the suspicion for cystic biliary atresia. The diagnosis was confirmed with intraoperative cholangiography (IOC) and Kasai procedure was done. The patient was well after the surgery with resolution of jaundice.

Genetic and clinical features of patients with intrahepatic cholestasis caused by citrin deficiency.

Citrin deficiency (CD) is an autosomal recessive disease caused by mutations of the SLC25A13 gene, plasma bile acid profiles detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS) could be an efficient approach for early diagnosis of intrahepatic cholestasis. The aim of this study was to investigate the genetic testing and clinical characteristics of a series of patients with CD, and to analyse plasma bile acid profiles in CD patients. We retrospectively analysed data from 14 patients (12 males and 2 females, age 1-18months, mean 3.6months) with CD between 2015 and 2021, including demographics, biochemical parameters, genetic test results, treatment, and clinical outcomes. In addition, 30 cases (15 males and 15 females, age 1-20months, mean 3.8months) with idiopathic cholestasis (IC) served as a control group. Plasma 15 bile acid profiles were compared between the CD and IC groups. Eight different mutations of the SLC25A13 gene were detected in the 14 patients diagnosed with CD, of which three novel variants of the SLC25A13 gene were investigated, the c.1043C>T (p.P348L) in exon11, the c.1216dupG (p.A406 Gfs*13) in exon12 and the c.135G>C (p.L45F) in exon3. More than half of the patients with CD had prolonged neonatal jaundice, which was associated with significantly higher alpha-fetoprotein (AFP) levels, hyperlactatemia and hypoglycemia. The majority of patients were ultimately self-limited. Only one patient developed liver failure and died at the age of 1 year due to abnormal coagulation function. In addition, the levels of glycochenodeoxycholic acid (GCDCA), taurocholate (TCA), and taurochenodeoxycholic acid (TCDCA) were significantly increased in the CD group compared with those in the IC group. Three novel variants of the SLC25A13 gene were identified for the first time, providing a reliable molecular reference and expanding the SLC25A13 gene spectrum in patients with CD. Plasma bile acid profiles could be a potential biomarker for non-invasive early diagnosis of patients with intrahepatic cholestasis caused by CD.

A Rare Case of Congenital Hypothyroidism

Congenital Hypothyroidism (CH) is a common preventable cause of mental retardation. The incidence of CH is 1 in 2500 to 1 in 3000 newborns. Most common causes are thyroid dysgenesis and dyshormonogenesis. Some disorder like maternal autoantibodies, maternal intake of anti thyroid medication, iodine deficiency or iodine excess can result in transient CH. Common symptoms include decreased activity and increased sleep, feeding difficulty, constipation, and prolonged jaundice. In this case report, A 3 day old baby was admitted to SNCU with chief complain of yellowish discoloration upto abdomen and respiratory distress. On examination, common signs include myxedematous facies, large fontanels, macroglossia, a distended abdomen with umbilical hernia, and hypotonia. Thyroid dysgenesis accounts for 85% of permanent, primary CH, while inborn errors of thyroid hormone biosynthesis (dyshormonogeneses) account for 10-15% of cases. Secondary or central CH may occur with isolated TSH deficiency, but more commonly it is associated with congenital hypopitiutarism. Transient CH most commonly occurs in preterm infants born.

Clinical Significance of Plasma Tenascin-C Levels in Recipients With Prolonged Jaundice After Living Donor Liver Transplantation

Focusing on tenascin-C (TNC), whose expression is enhanced during the tissue remodeling process, the present study aimed to clarify whether plasma TNC levels after living donor liver transplantation (LDLT) could be a predictor of irreversible liver damage in the recipients with prolonged jaundice (PJ). Among 123 adult recipients who underwent LDLT between March 2002 and December 2016, the subjects were 79 recipients in whom we could measure plasma TNC levels preoperatively (pre-) and on postoperative days 1 to 14 (POD1 to POD14). Prolonged jaundice was defined as serum total bilirubin level >10 mg/dL on POD14, and 79 recipients were divided into 2 groups: 56 in the non-PJ (NJ) group and 23 in the PJ group. The PJ group had significantly increased pre-TNC; smaller grafts; decreased platelet counts POD14; increased TB-POD1, -POD7, and -POD14; increased prothrombin time-international normalized ratio on POD7 and POD14; and higher 90-day mortality than the NJ group. As for the risk factors for 90-day mortality, multivariate analysis identified TNC-POD14 as a single significant independent prognostic factor (P=.015). The best cut-off value of TNC-POD14 for 90-day survival was determined to be 193.7 ng/mL. In the PJ group, the patients with low TNC-POD14 (<193.7 ng/mL) had satisfactory survival, with 100.0 % at 90 days, while the patients with high TNC-POD14 (≥193.7 ng/mL) had significantly poor survival, with 38.5 % at 90 days (P=.004). In PJ after LDLT, plasma TNC-POD14 is very useful for diagnosing postoperative irreversible liver damage early.

SLCO1B1 and SLCO1B3 genetic mutations in Taiwanese patients with Rotor syndrome

Rotor syndrome is a rare, benign, inherited disorder that is commonly associated with mild hyperbilirubinemia. It is caused by bi-allelic pathological variants in both SLCO1B1 and SLCO1B3 genes, causing defective OATP1B1 and OATP1B3 in the sinusoidal membrane and interrupted bilirubin uptake of the hepatocytes. We report five Taiwanese pediatric and adult patients aged 5–32 years presenting with conjugated hyperbilirubinemia, and were found to have genetic variants of SLCO1B1 and SLCO1B3. Two also had history of prolonged neonatal jaundice. Genetic analysis using panel-based next generation sequencing revealed three patients with homozygous mutations c.1738C>T (p.R580∗) in SLCO1B1 and a transposon LINE-1 insertion in SLCO1B3, one patient with homozygous mutations for another haplotype, c.757C>T (p.R253∗) in SLCO1B1 and c.1747+1G>A in SLCO1B3. Another patient had heterozygous c.1738C>T (p.R580∗) in SLCO1B1 linked with a LINE-1 insertion in SLCO1B3, and heterozygous c.757C>T (p.R253∗) in SLCO1B1 linked with c.1747+1G>A in SLCO1B3. In conclusion, we present the first time of genetic diagnosis of Rotor syndrome in Taiwan. Advanced genetic testing has enhanced the diagnosis of rare diseases with mild symptoms.

Angiographic patterns of portal venous system in children with extrahepatic portal hypertension and its etiological and clinical relevance.

To study the relationship between the angiographic pattern of extrahepatic portal vein obstruction (EHPVO) and its etiology and clinical manifestations. Clinical, etiological, and angiographic findings in 155 children with EHPVO were reviewed. Anatomy of extrahepatic portal venous system (EPVS) was categorized into five imaging patterns. Assessment of the severity of esophageal and gastric varices (EV and GV) was performed by upper gastrointestinal endoscopy. Based on multislice CT angiography, most commonly observed pattern of EHPVO was type I (48.4%) and type II (29%). According to anamnesis, 68 (43.8%) children had pathological conditions in neonatal period. Of these, 35 (22.6%) had an umbilical vein catheterization, 11 (7.1%) had a history of omphalitis, and 9 (5.8%) had prolonged jaundice. Thirteen (8.4%) patients had various septic conditions in neonatal period and it was more common associated with widespread thrombosis throughout the EPVS (type 5)-28% of observations. Significantly lower risk of bleeding from EV (p = 0.01) was noted in children with type IV pattern, whereas children with type III and V patterns had higher grades of EV. Angiographic pattern of portomesenteric occlusion may provide a clue to its etiology, and clinical manifestation, especially in children with widespread thrombosis throughout the EPVS.

Prolonged jaundice after previous SARS-CoV-2 infection: a clinical case report

The hepatobiliary system can be affected by a new coronavirus infection (COVID-19), in addition to the respiratory organs. Vanishing bile duct syndrome (VBDS) is a rare cause of jaundice that usually develops as a result of drug-induced liver injury or possibly due to the combined effect of several etiological factors.Clinical case. A 77-year-old patient was hospitalized due to jaundice, skin itching and dark urine. Symptoms first appeared 1 month after COVID-19 treated with ceftriaxone and were accompanied by an increase in biochemical markers of cholestasis. Both extra- and intrahepatic bile ducts injuries were excluded. Liver histology revealed VBDS. Treatment with ursodeoxycholic acid for 11 months led to complete resolution of jaundice, regression of pruritus and a decrease in biochemical markers of cholestasis.Discussion. This clinical case is of interest in connection with the development of VBDS in a patient after coronavirus pneumonia treated with ceftriaxone. VBDS is rarely included in the differential diagnosis of cholestatic syndrome, which is partly due to the lack of awareness of physicians about the complications that develop after COVID-19 and drug therapy.

An Implicit Cause of Prolonged Neonatal Jaundice: Vitamin B12 Deficiency

Abstract Objective Prolonged jaundice is defined as a serum bilirubin level of more than 5 mg/dL, which persists at postnatal 14 days in term infants and 21 days following birth in preterm infants. Although the underlying causes cannot be found in the majority of prolonged jaundice cases, this may be the first sign of a serious issue. Therefore, this study aimed to evaluate the association between vitamin B12 deficiency and prolonged jaundice in newborns. Material and Methods This descriptive cross-sectional study was performed in a university hospital between January 1, 2015 and October 1, 2020. All participants consisted of infants who were admitted to the pediatric outpatient clinics. Infants &gt; 35 weeks of gestation and with prolonged jaundice of unknown etiology were included in the study group. The control group consisted of infants &gt; 35 weeks of gestation without prolonged jaundice. Demographic and clinical characteristics and serum vitamin B12 levels were evaluated comparatively. Results A total of 126 infants, 66 of whom had prolonged jaundice, were included. The mean gestational week of the study group was 38.4 ± 1.8, and the control group was 38.6 ± 1.9 weeks. There was no difference between the groups in terms of demographics and laboratory data. The vitamin B12 level of the study group was significantly lower (median = 170 pg/mL) than the control (median = 268 pg/mL). Conclusion Based on the findings of this study, vitamin B12 deficiency was thought to be an important cause of prolonged jaundice, and further studies are needed to explain the role of vitamin B12 deficiency in the etiology of prolonged jaundice.

The Effect of Clofibrate and Phototherapy on Prolonged Jaundice due to Breast Milk in Full-Term Neonates.

Jaundice is one of the most common problems during infancy. It is believed that breast milk jaundice is one of the reasons for the persistence of jaundice after 14 days of prolonged jaundice. This study evaluates the effect of Clofibrate and phototherapy on prolonged jaundice originating from breast milk in term and healthy neonates. This double-blind clinical trial study was performed on 100 randomly divided neonates in the neonatal ward of Besat Hospital. In addition to phototherapy, the case group received a single dose of edible Clofibrate (50 mg/kg) dissolved in 2 CCs of distilled water. The control group received the same amount of distilled water as the phototherapy group. After treatment, bilirubin change rate, duration of hospitalization, and any association with gender, gestational age, hemoglobin, blood type, and Rh of neonates were determined and compared throughout the 2 groups. Data analysis showed that the bilirubin reduction rate was statistically significantly higher in the case group than in the control group (P < .05). The mean duration of hospitalization and phototherapy in the case group was significantly lower than in the control group (P = .005). The bilirubin reduction rate was not affected significantly by gestational age, blood type, or Rh. This study's results demonstrated that Clofibrate effectively decreased bilirubin levels and shortened the duration of phototherapy and hospitalization in infants with probable breast milk jaundice. IRCT2012092910933N1.

Use of Red Cell Indices for Screening of Hereditary Spherocytosis in Neonates: A Report of Two Cases Confirmed by Exome Sequencing

Prolonged unconjugated hyperbilirubinaemia is defined as neonatal jaundice persisting beyond 14 days of life. Hereditary Spherocytosis (HS) often remains underdiagnosed and is a notable cause of prolonged neonatal jaundice. Coombs negative haemolytic anaemias are an important cause of unconjugated hyperbilirubinaemia, and HS is one of the most common inherited red cell membrane disorders. Other causes of prolonged unconjugated jaundice include extravasated blood (cephalhaematoma, bruises, intraventricular haemorrhage in preterm infants), haemolysis (blood group incompatibility, red blood cell enzymopathies, and membranopathies), urinary tract infection, congenital hypothyroidism, and rare familial disorders such as Gilbert’s syndrome and Crigler-Najjar syndromes I and II. Herein, the authors present a case report of two male neonates (three week-old and 25dayold) who presented with hyperbilirubinaemia requiring intensive phototherapy, blood transfusion, an exchange transfusion, and were diagnosed with HS. A significant family history suggested haemolytic anaemia, and red cell indices, namely Mean Corpuscular Haemoglobin Concentration (MCHC), Mean Corpuscular Volume (MCV), and the ratio of MCHC/MCV (neonatal HS index), helped suspect HS. Whole exome sequencing identified the specific mutation and confirmed the diagnosis of HS. Both of these neonates presented with prolonged neonatal jaundice, and HS was suspected based on the family history and red cell indices, namely MCHC and MCHC/MCV ratio, as highlighted in the present case series.

Современные принципы организации питания у поздних недоношенных новорожденных

Neonates born between 34 0/7 and 36 6/7 weeks of gestation are considered late preterm (LPT) and constitute the largest group of all preterm infants. The rate of morbidity and mortality, as well as the frequency of repeated hospitalizations among LPT infants are significantly higher compared to full-term infants, which is explained by immaturity due to the lack of a critical period of their intrauterine growth and development. Fairly common they face nutritional problems leading to adverse immediate and long-term outcomes. Until recently, the lack of clear feeding recommendations for LPT infants determined the use of individual approaches to optimize their nutrition. The annual increase in the number of LPT infants has prompted the accumulation of new scientific information concerning both the anatomical and physiological characteristics and principles of development of these children in general and specific problems, including those related to nutrition. Comprehensive support and appropriate breastfeeding are the cornerstone of adequate nutrition for LPT infants. Depending on factors such as gestational age, birth weight, and comorbidities, it is often necessary to increase nutritional support, including the use of breast milk fortifiers, nutrientenriched formulas, and parenteral nutrition prescription. The process of achieving normal nutritional status in LPT infants can be complicated by episodes of hypoglycemia and prolonged jaundice, delay in postnatal growth and development, which requires a special approach. This review highlights the most common problems of nutritional management of LPT infants and provides current recommendations for optimal feeding of this group of preterm infants. Key words: late preterm infant, nutritional requirements, breastfeeding, donor milk, specialized formula, breast milk fortifiers, hypoglycemia, hyperbilirubinemia