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

Heidi Al-Wassia; Andrew W. Lyon; Sarah M. Rose; Reginald S. Sauve; Tanis R. Fenton

doi:10.1055/s-0039-1677713

American Journal of Perinatology, Table of Contents

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

¹Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia

,

Andrew W. Lyon

²Department of Pathology and Laboratory Medicine, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada

,

Sarah M. Rose

³Research Facilitation, Alberta Health Services, Calgary, Alberta, Canada

,

Reginald S. Sauve

⁴Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada

⁵Community 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

⁵Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

⁶Nutrition Services, Alberta Health Services, Calgary, Alberta, Canada

› Author Affiliations

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

Full Text

References

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