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Am J Perinatol 2019; 36(13): 1412-1419
DOI: 10.1055/s-0039-1677713
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hypophosphatemia is Prevalent among Preterm Infants Less than 1,500 Grams

Heidi Al-Wassia 
1   Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
,
Andrew W. Lyon
2   Department of Pathology and Laboratory Medicine, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
,
Sarah M. Rose
3   Research Facilitation, Alberta Health Services, Calgary, Alberta, Canada
,
Reginald S. Sauve
4   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
5   Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
,
Tanis R. Fenton
5   Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
6   Nutrition Services, Alberta Health Services, Calgary, Alberta, Canada
› Author Affiliations Funding This study was funded by ASPEN Rhodes Research Foundation and Alberta Children's Hospital Foundation.
Further Information

Publication History

26 September 2018

17 December 2018

Publication Date:
21 January 2019 (online)

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Abstract

Objective This article identifies the prevalence and associated factors of hypophosphatemia (HP) in very low birth weight (VLBW) infants in the first week of life.

Study Design Prospective exploratory cohort study of 106 consecutive VLBW infants admitted to neonatal intensive care at Foothills Hospital, Calgary, Canada. HP was defined as at least one measurement of serum phosphate < 1.5 mmol/L (4.5 mg/dL).

Results Seventy-seven percent (82/106) of the VLBW infants had HP, with significantly higher prevalence in infants < 1,000 g (94%) compared to infants ≥ 1,000 g (61%) (p < 0.001). Hypophosphatemic infants had lower birth weight (p < 0.001), gestational age (p < 0.001), and their increase in phosphate intake was slower (p = 0.003). Respiratory distress syndrome (RDS) (p = 0.002), intraventricular hemorrhage (IVH) ≥ grade III (p = 0.020), and hyperglycemia (p = 0.013) were more frequent among hypophosphatemic infants, especially among those < 1,000 g. Mortality, seizures, arrhythmias, and need for transfusion were not different between groups. Birth weight modified the association between RDS, IVH, hyperglycemia, and HP.

Conclusion HP was ubiquitous among infants < 1,000 g and highly prevalent among those weighing 1,000 to 1,500 g. While the direction of effect was not clear, RDS, IVH, and hyperglycemia were associated with HP. Prevention of HP in these physiologically immature neonates might improve neonatal outcomes.

Keywords

hypophosphatemia - very low birth weight - risk factors - preterm infants

Dr. Heidi Al-Wassia's ORCID is 0000-0002-8208-4986.


Supplementary Material

 

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