Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 10:42:e2022152.
doi: 10.1590/1984-0462/2024/42/2022152. eCollection 2023.

Factors associated with cholestasis in newborns with gastroschisis

Juliana Zoboli Del Bigio  1 , Ana Cristina Aoun Tannuri  1 , Mário Cícero Falcão  1 , Felipe Yu Matsushita  1 , Werther Brunow de Carvalho  1
Affiliations

Factors associated with cholestasis in newborns with gastroschisis

Juliana Zoboli Del Bigio et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

Objective: To describe the incidence and to analyze risk factors associated with cholestasis in neonates with gastroschisis.

Methods: This is a retrospective cohort study in a tertiary single center analyzing 181 newborns with gastroschisis between 2009 and 2020. The following risk factors associated with cholestasis were analyzed: gestational age, birth weight, type of gastroschisis, silo closure or immediate closure, days of parenteral nutrition, type of lipid emulsion, days of fasting, days to reach a full diet, days with central venous catheter, presence of infections, and outcomes.

Results: Among the 176 patients evaluated, 41 (23.3%) evolved with cholestasis. In the univariate analysis, low birth weight (p=0.023), prematurity (p<0.001), lipid emulsion with medium-chain triglycerides and long-chain triglycerides (p=0.001) and death (p<0.001) were associated with cholestasis. In the multivariate analysis, patients who received lipid emulsion with fish oil instead of medium chain triglycerides/long chain triglycerides (MCT/LCT) emulsion had a lower risk of cholestasis.

Conclusions: Our study shows that lipid emulsion with fish oil is associated with a lower risk of cholestasis in neonates with gastroschisis. However, this is a retrospective study and a prospective study should be performed to confirm the results.

Objetivo:: Analisar a incidência e os fatores de risco associados à colestase em recém-nascidos com gastrosquise.

Métodos:: Estudo de coorte retrospectivo em um único centro terciário, que analisou 181 recém-nascidos com gastrosquise entre 2009 e 2020. Foram examinados os seguintes fatores de risco associados à colestase: idade gestacional, peso ao nascer, tipo de gastrosquise, fechamento com silo ou fechamento imediato, dias de uso nutrição parenteral, tipo de emulsão lipídica, dias de jejum, dias para atingir a dieta completa, dias com cateter venoso central, presença de infecções e desfechos.

Resultados:: Dos 176 pacientes avaliados, 41 (23,3%) evoluíram com colestase. Baixo peso ao nascer (p=0,023), prematuridade (p<0,001), emulsão lipídica com triglicerídeos de cadeia média e triglicerídeos de cadeia longa (p=0,001) e óbito (p<0,001) foram associados à colestase. Na análise multivariada, os pacientes que receberam emulsão lipídica com óleo de peixe em vez da emulsão diária de triglicérides de cadeia média/triglicérides de cadeia longa (MCT/LCT) apresentaram menor risco de colestase.

Conclusões:: Nosso estudo mostra que a emulsão lipídica com óleo de peixe está associada a menor risco de colestase em neonatos com gastrosquise, porém este é um estudo retrospectivo, e um estudo prospectivo deve ser realizado para confirmar os resultados.

PubMed Disclaimer

Conflict of interest statement

Conflict of interests The authors declare there is no conflict of interests.

Similar articles

See all similar articles

References

    1. Suver D, Lee SL, Shekherdimian S, Kim SS. Left-sided gastroschisis: higher incidence of extraintestinal congenital anomalies. Am J Surg. 2008;195:663–6. doi: 10.1016/j.amjsurg.2007.12.042. discussion 666. - DOI - PubMed
    1. Kirby RS, Marshall J, Tanner JP, Salemi JL, Feldkamp ML, Marengo L, et al. Prevalence and correlates of gastroschisis in 15 states, 1995 to 2005. Obstet Gynecol. 2013;122:275–81. doi: 10.1097/AOG.0b013e31829cbbb4. - DOI - PMC - PubMed
    1. Lakshminarayanan B, Lakhoo K. Abdominal wall defects. Early Hum Dev. 2014;90:917–20. doi: 10.1016/j.earlhumdev.2014.09.018. - DOI - PubMed
    1. Vu LT, Nobuhara KK, Laurent C, Shaw GM. Increasing prevalence of gastroschisis: population-based study in California. J Pediatr. 2008;152:807–11. doi: 10.1016/j.jpeds.2007.11.037. - DOI - PubMed
    1. Bergholz R, Boettcher M, Reinshagen K, Wenke K. Complex gastroschisis is a different entity to simple gastroschisis affecting morbidity and mortality-a systematic review and meta-analysis. J Pediatr Surg. 2014;49:1527–32. doi: 10.1016/j.jpedsurg.2014.08.001. - DOI - PubMed