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Multicenter Study
. 2022 Aug;42(8):1063-1069.
doi: 10.1038/s41372-022-01361-1. Epub 2022 Feb 28.

Early high amino-acid intake is associated with hypophosphatemia in preterm infants

Maria Fernanda Galletti  1 , Pablo Hernan Brener Dik  2 , Silvia Anahi Fernandez Jonusas  2 , Debora Sabatelli  3 , Carla Chiesa  4 , Silvana Perez  5 , Mariana Brusadin  6 , Larissa Genes  7 , Isabel Araya  8 , Gonzalo Luis Mariani  2
Affiliations
Multicenter Study

Early high amino-acid intake is associated with hypophosphatemia in preterm infants

Maria Fernanda Galletti et al. J Perinatol. 2022 Aug.

Abstract

Objective: To estimate the incidence of hypophosphatemia in preterm infants according to parenteral nutrition received and to evaluate associated risk factors.

Design: A prospective multicenter cohort study included 111 patients ≤ 1250 g (7 NICUs of the NEOCOSUR Network). Two groups were compared according to the amino-acid supply in the first 48 h: aggressive parenteral group ≥ 3 g/kg/day and standard parenteral group: <2.9 g/kg/day. Hypophosphatemia was defined as serum phosphate < 4 mg/dl. A logistic regression analysis was performed to evaluate associated risk factors.

Results: Fifty-eight infants received aggressive parenteral nutrition. The incidence of hypophosphatemia was significantly higher in the aggressive parenteral group (77.5% vs 53.8%, p = 0.009). Hypophosphatemia was independently associated with aggressive parenteral nutrition (aOR 4.16 95% CI 1.54-12.24) and negatively associated with phosphorous intake (aOR 0.92 95% CI 0.87-0.97).

Conclusion: Both high amino-acid intake and low phosphorus supply during the first days after birth were independently associated with hypophosphatemia.

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