Nutritional status of infants with neonatal cholestasis

Purpose We constructed a study to determine the association of anthropometric measurements, biochemical parameters and bone mineral content with nutritional status in infants with neonatal cholestasis. Methods The study included 38 children with neonatal cholestasis. Nutritional status was assessed by Waterlow criteria, and anthropometric measurements, biochemical parameters and bone mineral content were correlated with the nutritional status at initial admission and at the end of 2 months after nutritional support. Results We found that the prevalence of acute and chronic malnutrition was 34.2% and 39.4% in infants with neonatal cholestasis, respectively. No significant difference was found in triceps skinfold thickness (TST), scapular skinfold thickness (SST) and suprailiac skinfold thickness (SuST), arm fat area (AFA) and arm area (AA) among the groups. Mid-arm circumference (MAC), arm muscle circumference (AMC) and arm muscle area (AMA) were significantly lower in patients with chronic malnutrition than both acute malnutrition and patients without malnutrition. MAC was the most reliable marker for the assessment of malnutrition and had the highest positive predictive value (PPV) (80.6%), sensitivity (89.2%) and negative predictive value (NPV) (57.1%). Prealbumin levels were significantly lower in patients with chronic malnutrition than the patients without malnutrition. Increment in MAC and AMC were significantly high in the three groups after 2 months. Conclusion MAC is a good indicator of malnutrition in neonatal cholestasis and may also be used for the monitoring of nutritional support; prealbumin may be used for assessment of the severity of malnutrition.