Medicine of the Future in America

Transient cholestasis in newborn infants with perinatal asphyxia: Further characteristics

Alanine aminotransferase and aspartate aminotransferase were measured in eight of 20 cholestatic infants and normalized in all after the end of total parenteral nutrition (TPN). Bilirubin values were controlled in 13 of 20 cholestatic patients until normalization occured.

Emergency cesarean section was performed in 55.2% of pregnancies with asphyxiated neonates (82 in AGA and 18 in SGA), and in 12 of 20 (60%) children with additional transient neonatal cholestasis.

AGA children were born prematurely in 50.9% (83 of 163) versus 86% (12 of 14) of AGA asphyxiated children with transient neonatal cholestasis. SGA children were born prematurely in 77.3% (17 of 22) versus 83% (five of six) of cases of cholestasis (Table 2).

Intubation and ventilation were necessary in 113 of 163 (69.0%) of the asphyxiated AGA infants and in 16 of 18 (89%) of the asphyxiated SGA neonates. The average duration of ventilation in AGA children without cholestasis was 5.4 days (median one day, range zero to 91 days) versus 20.5 days (median 13 days, range five to 114 days) in those with cholestasis (P<0.0001). In SGA infants without cholestasis, the average duration of ventilation was 13.3 days (median 3.5 days, range zero to 84 days), and for those with cholestasis it was 43 days (median 22.5 days, range five to 116 days) (P=0.04, Mann-Whitney U test). Multivariate analysis of sex, apgar scores, gestational age and duration of ventilation showed an increased risk of developing cholestasis for children of any weight born before the age of 35 weeks (2.84, CI 1.08.1).

TABLE 2 Comparison of clinical characteristics of neonates with appropriate birth weight for gestational age (AGA), and small birth weight for gestational age (SGA) with asphyxia, with and without cholestasis (CS), with regard to sex, gestational age in weeks and birth weight (grams) You can be sure this pharmacy will offer the finest quality drugs you need, so buying birth control alesse >>> will always be safe and very pleasant for you as a customer and patient.

Neonates Asphyxia and AGA without CS n=148 Asphyxia and AGA with CS n=14 Asphyxia and SGA without CS P* n=12 Asphyxia and SGA with CS n=6 P*
Sex 66f/83m 4f/10m 7f/5m 3f/3m
Gestational age 36 (5) 32 (5) 0.005 34 (3) 34 (4) 0.8
mean (SD)
Birthweight 2,705 (982) 1,973 (973) 0.01 1,529 (695) 1,637 (604) 0.9
mean (SD)

*Mann-Whitney U test. f Female; m Male

This entry was posted in Transient cholestasis and tagged Asphyxia, Cholestasis, Newborn.
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