Neonatal Center, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, No.1 Shunkang Road, Shunyi District Beijing, Beijing, 101300, China.
BMC Pediatr. 2024 Apr 16;24(1):255. doi: 10.1186/s12887-024-04737-8.
Physiological processes rely on phosphate, which is an essential component of adenosine triphosphate (ATP). Hypophosphatasia can affect nearly every organ system in the body. It is crucial to monitor newborns with risk factors for hypophosphatemia and provide them with the proper supplements. We aimed to evaluate the risk factors and develop a nomogram for early hypophosphatemia in term infants.
We conducted a retrospective study involving 416 term infants measured serum phosphorus within three days of birth. The study included 82 term infants with hypophosphatemia (HP group) and 334 term infants without hypophosphatemia (NHP group). We collected data on the characteristics of mothers, newborn babies, and childbirth. Furthermore, univariate and multivariate logistic regression analyses were performed to identify independent risk factors for hypophosphatemia in term infants, and a nomogram was developed and validated based on the final independent risk factors.
According to our analysis, the multivariate logistic regression analysis showed that male, maternal diabetes, cesarean delivery, lower serum magnesium, and lower birth weight were independent risk factors for early hypophosphatemia in term infants. In addition, the C-index of the developed nomogram was 0.732 (95% CI = 0.668-0.796). Moreover, the calibration curve indicated good consistency between the hypophosphatemia diagnosis and the predicted probability, and a decision curve analysis (DCA) confirmed the clinical utility of the nomogram.
The analysis revealed that we successfully developed and validated a nomogram for predicting early hypophosphatemia in term infants.
生理过程依赖于磷酸盐，它是三磷酸腺苷（ATP）的重要组成部分。低磷酸酶症可影响体内几乎所有的器官系统。监测有低磷血症风险的新生儿并为其提供适当的补充剂至关重要。我们旨在评估风险因素，并为足月婴儿早期低磷血症制定一个列线图。
我们进行了一项回顾性研究，纳入了 416 名出生后三天内测量血清磷的足月婴儿。该研究包括 82 名有低磷血症的足月婴儿（HP 组）和 334 名无低磷血症的足月婴儿（NHP 组）。我们收集了母亲、新生儿和分娩的特征数据。此外，进行了单变量和多变量逻辑回归分析，以确定足月婴儿低磷血症的独立危险因素，并根据最终的独立危险因素制定和验证了一个列线图。
根据我们的分析，多变量逻辑回归分析表明，男性、母亲患有糖尿病、剖宫产、血清镁水平较低和出生体重较低是足月婴儿早期低磷血症的独立危险因素。此外，所开发列线图的 C 指数为 0.732（95%CI=0.668-0.796）。此外，校准曲线表明列线图在预测低磷血症方面与实际诊断之间具有良好的一致性，决策曲线分析（DCA）也证实了该列线图的临床实用性。
分析表明，我们成功地为足月婴儿早期低磷血症制定并验证了一个列线图。
