Prevalence and clinical characterization of neonatal cholestasis in a tertiary care hospital over a 4-year period

Abstract

Introduction: Neonatal cholestasis is defined as decreased bile flow and/or excretion leading to accumulation of substances that are normally excreted by bile into the intestine. Biochemically, it is characterized by a direct blood bilirubin level > 1 mg/dl (17 µmol/L). The incidence ranges from 1 to 2500 term newborns. Diseases causing cholestasis include a large number of etiologies ranging from genetic disorders to infectious pathologies. Timely diagnosis and initiation of treatment for treatable causes of cholestasis are crucial to limit progressive liver damage and prevent injury to other organs. Objective: To establish the prevalence and clinical characteristics of neonatal cholestasis in a tertiary care university hospital in Cúcuta, Colombia. Materials and methods: Observational, retrospective, and descriptive study. A total review of six hundred and one medical record was conducted, of which forty-two medical records were included in our study. Mean and standard deviation were calculated for quantitative variables and frequency and percentages for qualitative variables. Statistical analysis was performed with Epi Info™ Version 7.2. Results: The number of live births in the 4 years was 25447, reaching a proportion of four cases per 2500 live births, with a male predominance of 69%. Among the etiologies, infectious causes accounted for 59.5%, parenteral nutrition and without specific etiology represented 21.4%, obstructive causes 16.7% and metabolic causes 2.4%. Conclusion: In our study we identified that infectious etiology represented the main cause of cholestasis as well as exposure to antibiotics and exposure to parenteral nutrition.