Neonatology, Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Hospital Fernandez, Buenos Aires, Argentina.
J Perinatol. 2022 Aug;42(8):1063-1069. doi: 10.1038/s41372-022-01361-1. Epub 2022 Feb 28.
To estimate the incidence of hypophosphatemia in preterm infants according to parenteral nutrition received and to evaluate associated risk factors.
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.
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).
Both high amino-acid intake and low phosphorus supply during the first days after birth were independently associated with hypophosphatemia.
根据接受的肠外营养情况，估计早产儿低磷血症的发生率，并评估相关危险因素。
前瞻性多中心队列研究纳入了 111 名体重≤1250g 的患者（NEOCOSUR 网络的 7 个 NICU）。根据前 48 小时的氨基酸供应，将两组患者进行比较：积极肠外组≥3g/kg/天和标准肠外组：<2.9g/kg/天。低磷血症定义为血清磷<4mg/dl。采用逻辑回归分析评估相关危险因素。
58 名婴儿接受了积极的肠外营养。积极肠外组低磷血症的发生率明显更高（77.5%比 53.8%，p=0.009）。低磷血症与积极肠外营养（优势比 4.16，95%置信区间 1.54-12.24）和磷摄入减少（优势比 0.92，95%置信区间 0.87-0.97）独立相关。
出生后最初几天高氨基酸摄入和低磷供应均与低磷血症独立相关。
