Thrombocytopenia at Birth Is a Predictor of Cholestasis in Infants with Small for Gestational Age

Cholestasis and thrombocytopenia are complications that affect infants born small for gestational age (SGA). In SGA infants, other vital organs develop at the expense of the liver, and the thrombopoietin produced by the liver is low, often resulting in cholestasis. We hypothesized that thrombocytopenia at birth can be used to predict cholestasis in very-low-birth-weight infants (VLBWIs) with SGA. This retrospective cohort study enrolled VLBWIs with SGA admitted to a tertiary neonatal intensive care unit. A platelet cutoff value predictive of cholestasis was determined using receiver operating characteristic analysis. Multivariate logistic regression analysis was performed to evaluate the platelet cutoff value, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Regarding the onset of cholestasis, survival analysis was performed by calculating the adjusted hazard ratios (HRs) and 95% CIs. A total of 87 infants were evaluated, and the platelet cutoff value was determined as 88×10(3) cells/μl. The adjusted OR for this platelet cutoff value was 10.52 (95% CI 2.26-55.93, p＝0.003), and the adjusted HR was 7.76 (95% CI 2.51-23.50, p＝0.0006). Thrombocytopenia is a useful predictor for cholestasis in VLBWIs with SGA.