Incidence and Risk Factors of Parenteral Nutrition-Associated Cholestasis in Omani Neonates Single centre experience
Journal Title: Sultan Qaboos University Medical Journal - Year 2015, Vol 15, Issue 2
Abstract
Objectives: Parenteral nutrition-associated cholestasis (PNAC) is one of the most challenging complications of prolonged parenteral nutrition (PN) in neonates. Tere is a lack of research investigating its incidence in newborn infants in Oman and the Arab region. Terefore, this study aimed to assess the incidence of PNAC and its risk factors in Omani neonates. Methods: Tis retrospective study took place between January and April 2014. All neonates who received PN for ≥14 days during a four-year period (June 2009 to May 2013) at the neonatal intensive care unit (NICU) in Sultan Qaboos University Hospital, Muscat, Oman, were enrolled. Results: A total of 1,857 neonates were admitted to the NICU over the study period and 135 neonates (7.3%) received PN for ≥14 days. Determining the incidence of PNAC was only possible in 97 neonates; of these, 38 (39%) had PNAC. Te main risk factors associated with PNAC were duration of PN, duration of enteral starvation, gastrointestinal surgeries, blood transfusions and sepsis. Neonates with PNAC had a slightly higher incidence of necrotising enterocolitis in comparison to those without PNAC. Conclusion: Tis study found a PNAC incidence of 39% in Omani neonates. Tere were several signifcant risk factors for PNAC in Omani neonates; however, after logistic regression analysis, only total PN duration remained statistically signifcant. Preventive strategies should be implemented in NICUs so as to avoid future chronic liver disease in this population.
Authors and Affiliations
Sharef W. Sharef| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Siham Al-Sinani| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Khalid Al-Naamani| Department of Medicine, Armed Forces Hospital, Muscat, Oman, Ibrahim Al-Zakwani| Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Zenaida S. Reyes| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Hilal Al-Ryiami| Oman Medical Speciality Board, Muscat, Oman, Ashfaq A. Khan| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Watfa Al-Mamari| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
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