Tejedor Mestre María, Vetter-Laracy Susanne, Cobo Pilar, Bauçà Josep Miquel, Robles Juan, Forteza Francisca, Beltrán Eva
Department of Pediatrics, Division of Neonatology. Hospital Universitario Son Espases. IdISBa.
Department of Pediatrics, Division of Neonatology. Department of Laboratory Medicine. Hospital Universitario Son Espases.
Nutr Hosp. 2025 Jun 19;43(3):411-419. doi: 10.20960/nh.05609.
Background: as chromium (Cr) is known to contaminate components of parenteral nutrition (PN), Cr-free PN is recommended for preterm infants. Exposure to Cr by PN in preterm infants is scarcely investigated. Objective: to describe Cr levels in plasma (Crp) and urine (Cru) during the first month of life in premature newborns ≤ 1500 g of birthweight (BW) receiving PN, and to evaluate the impact on postnatal clinical parameters. Methods: a prospective observational study. Cr-free PN was administered at day 1 of life and continued until full enteral feeding with fortified breastmilk began. Crp levels at day 15 and 30 and Cru at day 30 of life were assessed according to demographic factors, biochemical markers and postnatal morbidity. Results: 97 infants had a median gestational age (GA) of 29.9 weeks, and a median BW of 1205 g. Median Crp remained at 1.0 µg/L at 15 and 30 days (IQR 0.7-1.4 and 0.7-1.3, respectively). Premature babies < 26 weeks had a significantly higher Crp at one month than the remainder (p = 0.043) and higher Cr elimination in the urine (p = 0.026). Crp increased with prolonged PN (p < 0.001), even after adjusting for gestational age (p = 0.001). Laboratory parameters were not influenced by Crp or Cru, nor was morbidity. Conclusion: Crp increases with days of PN even when a trace mineral supplement without Cr is used, and the level reached persists during the first month of life with the introduction of Cr-supplemented breastmilk feeding. No relation to morbidity was observed.
由于已知铬（Cr）会污染肠外营养（PN）的成分，因此建议为早产儿使用无铬PN。关于早产儿通过PN接触铬的情况鲜有研究。目的：描述出生体重（BW）≤1500g的早产新生儿在出生后第一个月接受PN期间血浆（Crp）和尿液（Cru）中的铬水平，并评估其对出生后临床参数的影响。方法：一项前瞻性观察性研究。在出生第1天开始给予无铬PN，并持续至开始完全经口喂养强化母乳。根据人口统计学因素、生化指标和出生后发病率评估出生第15天和30天的Crp水平以及出生第30天的Cru水平。结果：97名婴儿的中位胎龄（GA）为29.9周，中位BW为1205g。第15天和30天的Crp中位数分别保持在1.0μg/L（四分位间距分别为0.7 - 1.4和0.7 - 1.3）。孕周<26周的早产儿在1个月时的Crp显著高于其余婴儿（p = 0.043），尿铬排泄也更高（p = 0.026）。即使在调整胎龄后，Crp仍随PN时间延长而升高（p < 0.001，p = 0.001）。实验室参数不受Crp或Cru影响，发病率也不受影响。结论：即使使用不含铬的微量矿物质补充剂，Crp也会随PN天数增加，且在引入含铬母乳后，该水平在出生后第一个月持续存在。未观察到与发病率的相关性。
