Risk Factors for Cholestasis in Neonates Receiving Total Parenteral Nutrition: Single Center Cross Sectional Study

Background: Parenteral nutrition (PN) is vital treatment intended to provide patients who cannot meet their nutritional demands enterally with nutrients. It’s given to very low birth weights newborns. primary problem of prolonged PN is cholestasis, which incidence ranges from 15.7% to 60.9%.Aim: identifying critical variables thought to be main contributor to cholestasis in neonates receiving PN.Patients and Methods: cross sectional study of 114 neonates admitted to our university neonatal intensive care unit (NICU) was done from 1/3/2022 to 28/2/2023.Results: newborns were divided into group 1 (cholestatic group) &2 (non-cholestatic group) according to direct bilirubin level if ≥ 2 mg/dL or ≥ 1 mg/dL when total bilirubin level is ≤ 5 mg/dL, those neonates were included in cholestatic group. total incidence of cholestasis was13%. gender, gestational age, age at PN commencement, and PN length did not significantly differ between groups 1 and 2. according to bowel resection and necrotizing enterocolitis (NEC), there were substantial differences between group 1and group 2. Additionally, subgroup analysis revealed that PN length varied significantly across the subgroups that based on gestational age and PN duration. Demonstrated that probability of developing parenteral nutrition-associated cholestasis (PNAC) increased with PN length using multivariate logistic regression mode. PN administered for longer than cut-off points of 17.5 days had a high sensitivity and specificity for cholestasis, according to receiver operating characteristic curve (ROC) study.Conclusion: significant risk variables of PNAC in newborns were prolonged PN length, NEC incidence, and bowel resection.