{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T04:44:21Z","timestamp":1776401061992,"version":"3.51.2"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Neonatal cholestatic jaundice (cholestasis) has extensive aetiologies and occurs frequently in preterm infants in neonatal intensive care units (NICUs). Current multinational guidelines involve wide\u2010ranging investigations suited to general newborn populations without validation in NICU settings. We retrospectively reviewed New Zealand's guidelines for investigating cholestatic jaundice in the NICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Infants admitted to one tertiary NICU between 2008 and 2022 with direct bilirubin \u226520\u2009\u00b5mol\/L and percentage of total bilirubin \u226520% were identified from laboratory records. Investigations, health data and outcome data were obtained from clinical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cholestasis was detected in 208 (1.5% admissions) with median gestational age of 27 weeks and birth weight of 942\u2009g. Eight (3.8%) had primary liver diseases, all presenting in the early newborn period. Four (1.9%) with biliary atresia manifested cholestasis and acholic stool within 1\u2010month postnatal age; two were born preterm and survived &gt;5 years transplant\u2010free post\u2010portoenterostomy. There were no delayed or missed diagnoses of primary liver disease. The remaining 200 (96.2%) had hepatobiliary dysfunction related to preterm comorbidities, intestinal failure\u2010associated liver disease, cytomegalovirus infection, rare extrahepatic congenital disease or unknown causes. Investigations included liver biopsy in 28 (13.5%), hepatobiliary scintigraphy in 7 (3.4%), intraoperative cholangiography in 4 (1.9%) and 1 (0.5%) percutaneous cholangiogram. Overall, invasive testing for rare congenital diseases was done infrequently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most NICU infants with cholestasis did not have congenital diseases, and the small minority who did were all distinguishable by clinical factors regardless of gestation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70248","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:54:56Z","timestamp":1761908096000},"page":"165-174","source":"Crossref","is-referenced-by-count":0,"title":["Less is more: 15\u2010year audit of the evaluation of cholestatic jaundice in the neonatal intensive care unit"],"prefix":"10.1002","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7674-8185","authenticated-orcid":false,"given":"Zeba S.","family":"Moin","sequence":"first","affiliation":[{"name":"Department of Paediatric Gastroenterology Starship Child Health Auckland New Zealand"},{"name":"Department of Paediatrics: Child and Youth Health The University of Auckland Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amin J.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology Starship Child Health Auckland New Zealand"},{"name":"New Zealand National Intestinal Failure and Rehabilitation Service Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariam J.","family":"Buksh","sequence":"additional","affiliation":[{"name":"Starship Newborn Service Starship Child Health Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Knight","sequence":"additional","affiliation":[{"name":"Starship Newborn Service Starship Child Health Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen M.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology Starship Child Health Auckland New Zealand"},{"name":"New Zealand National Intestinal Failure and Rehabilitation Service Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.60.6.512"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001334"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001781"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3233\/NPM-230034"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intf.2025.100045"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.17343"},{"key":"e_1_2_8_8_1","unstructured":"National Women's Health Annual Clinical Reports Auckland Te Whatu Ora Health New Zealand: Te Toka Tumai; 2008 to 2022."},{"key":"e_1_2_8_9_1","unstructured":"Consensus Statement for Screening for Retinopathy of Prematurity: New Zealand Child and Youth Clinical Networks (NZCYCN). 2023.https:\/\/www.starship.org.nz\/guidelines\/consensus-statement-for-screening-for-retinopathy-of-prematurity\/"},{"key":"e_1_2_8_10_1","unstructured":"Guideline for Screening and Treatment of Retinopathy of Prematurity (ROP). 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