Yenidoğan Bebeklerde Neonatal Kolestaz İnsidansı ve Etiyolojisi

Öz

Amaç: Yenidoğan yoğun bakım ünitesinde yatan bebeklerde kolestaz sıklığının, karakteristik özelliklerinin, etiyolojilerinin, klinik ve laboratuvar verileri eşliğinde değerlendirilmesi amaçlandı.Gereç ve Yöntemler: Tek merkezli, retrospektif, 2016-2020 yıllarını kapsayan kohort çalışmaya direkt bilirubin değeri >2 mg/dl ya da total bilirubin seviyesi >5 mg/dl iken direkt bilirubin değerinin total bilirubinin >%20 olan yenidoğanlar alındı. Hastaların perinatal özellikleri, başvuru şikayetleri, klinik, laboratuvar verileri kaydedildi. Kolestaz nedenleri metabolik-genetik, sendromik, bilier, nutrisyonel, kardiyovasküler, enfeksiyon, endokrin ve sebebi açıklanamayan nedenler olarak gruplandırıldı. İstatistiksel değerlendirme üç temel grupta metabolik-genetik, parenteral-nutrisyonilişkili, diğerleri yapıldı. Bulgular: Neonatal kolestaz sıklığı 8,5/1000 yenidoğan olarak saptandı. En sık nedenleri parenteral nutrisyon %36,4 ile metabolik-genetik hastalıklar %32,7 oluşturdu. Çalışmaya alınan hastaların %76,4’ünü preterm-yenidoğanlar oluştururken, parenteral-nutrisyon grubundaki pretermler, gestasyon yaşı açısından en düşük hafta, doğum kilosu açısından ise en düşük doğum ağırlığına sahipti üç grup arasında sırasıyla p

Anahtar Kelimeler

• Yenidoğan, Kolestaz, Bilirubin, Sarılık

The Incidence and Etiology of Neonatal Cholestasis in Newborn Infants

Abstract

Objective: To evaluate the incidence, characteristic features, etiologies, and the clinical and laboratory outcome of neonatal cholestasis at the neonatal intensive care unit.Material and Methods: All newborns with direct bilirubin levels >2 mg/dl or 20% of total bilirubin when total bilirubin was >5 mg/dl were enrolled in this retrospective, single-center, cohort study. The perinatal characteristics, initial complaints, clinical and laboratory features were extracted. The etiology of cholestasis was recorded as metabolic-genetic conditions, syndromic, biliary, nutritional, cardiovascular, infectious, endocrine conditions and unknown origin. Statistical analyses were performed on three main group categories metabolic-genetic conditions, parenteral-nutritionassociated, and others .Results: The cholestasis incidence was 8.5/1000 live births. Parenteral-nutrition 36.4% and metabolic-genetic conditions 32.7% constituted the most common etiologies. The study population had a 76.4% rate of preterm delivery. Infants in theparenteral-nutrition group demonstrated earlier gestation p

Keywords

• Newborn, Neonatal cholestasis, Bilirubin, Jaundice

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