Biliary Atresia in Preterm Infants in Taiwan: A Nationwide Survey

Objectives To investigate the characteristics of biliary atresia (BA) in preterm infants. Study design Nationwide screening for BA in Taiwan using an infant stool color card was launched in 2004. We investigated the characteristics of BA in preterm infants using the national stool card registry center database. Results We identified 197 cases of BA from January 2004 to June 2010. The overall incidence of BA was 1.51 cases per 10 000 live births. The annual incidence of BA per 10 000 live births in term and preterm infants was 1.43 and 2.37 (P < .05), respectively. The sensitivity of detecting BA using stool cards before 60 days of age was 92.8% in term, and 96.3% in preterm infants. The Kasai operation before 60 days of age was 68.7% in term, and 44.4% in preterm infants. The jaundice-free rate at 3 months after the Kasai operation among infants with BA was 62.0% in term, and 37.0% in preterm infants (P = .015). The 18-month survival rate with native liver was higher in the term infants (72.7%) than that in the preterm infants (50.0%) (P = .043). Conclusion The incidence of BA in preterm infants is more frequent than in term infants. The stool color card is sensitive to detecting BA in preterm infants. Preterm infants with BA were more prone to delayed Kasai operation and had poorer outcome.