Prevalence of Parenteral Nutrition-Associated Liver Disease in Neonates With Congenital Heart Disease

Abstract Objective: Infants receiving parenteral nutrition (PN) are at increased risk of PN associated liver disease (PNALD) which can manifest in hepatic fibrosis. While congenital heart disease (CHD) represents a risk factor for hepatic fibrosis, this study sought to better understand if infants with CHD were at elevated risk of PNALD when receiving long-term PN. Study Design: A retrospective cohort of infants at a Level-IV NICU 2010-2020 who received long-term PN during the first 8-weeks of life. A 5000-iteration bootstrap estimation for time-varying cox-survival model was used to model risk of PNALD adjusted for demographics and PN exposure. Results: Neonates with CHD were found to be at higher risk for PNALD during or quickly following long-term PN exposure. Conclusions: This work offers a step in understanding how diagnoses can be factored into neonate PN prescription. Future work will explore lipid profiles and timing to mitigate risk in patients with CHD.