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

Journal of Perinatology volume 42, pages 1063–1069 (2022)Cite this article

Subjects

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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Fig. 1: Patient flowchart.
Fig. 2: Multivariate logistic regression model.

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Author information

Authors and Affiliations

  1. Neonatology, Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Maria Fernanda Galletti, Pablo Hernan Brener Dik, Silvia Anahi Fernandez Jonusas & Gonzalo Luis Mariani

  2. Hospital Fernandez, Buenos Aires, Argentina

    Debora Sabatelli

  3. Hospital Materno Infantil Ramón Sardá, Buenos Aires, Argentina

    Carla Chiesa

  4. Sanatorio Trinidad Palermo, Buenos Aires, Argentina

    Silvana Perez

  5. Hospital Español de Mendoza, Mendoza, Argentina

    Mariana Brusadin

  6. Hospital de Clínicas, Universidad Nacional de Asunción, Facultad de Medicina, San Lorenzo, Paraguay

    Larissa Genes

  7. Hospital Clínico San Borja Arriarán, Santiago, Chile

    Isabel Araya

Authors
  1. Maria Fernanda Galletti
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  2. Pablo Hernan Brener Dik
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  3. Silvia Anahi Fernandez Jonusas
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  4. Debora Sabatelli
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  5. Carla Chiesa
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  6. Silvana Perez
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  7. Mariana Brusadin
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  8. Larissa Genes
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  9. Isabel Araya
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  10. Gonzalo Luis Mariani
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Contributions

MFG was responsible for designing and writing the protocol, conducting the search, extracting, analyzing data, interpreting results, drafted the initial manuscript, and approved the final manuscript as submitted. PHBD contributed to the statistical analysis of data, revised the manuscript, and approved the final manuscript as submitted. SFJA aided in the design of the study, reviewed, and revised the manuscript, and approved the final manuscript as submitted. DS, CC, SP, MB, GL, and IA coordinated the study in their Institutions and contributed to the acquisition of patient’s data. They also revised the manuscript and approved the final manuscript as submitted. GLM mentored MFG in study conception, critically reviewed the manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Maria Fernanda Galletti.

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The authors declare no competing interests.

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Galletti, M.F., Brener Dik, P.H., Fernandez Jonusas, S.A. et al. Early high amino-acid intake is associated with hypophosphatemia in preterm infants. J Perinatol 42, 1063–1069 (2022). https://doi.org/10.1038/s41372-022-01361-1

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