Abstract
Objective
To investigate the incidence of early severe hypophosphatemia, and examine the associated clinical factors and outcomes, in extremely low birth weight infants (ELBWI) who received early amino acid administration.
Methods
Medical records of 82 ELBWI were retrospectively reviewed. Severe hypophosphatemia was defined as a serum phosphate level <2 mg/dL during the first week after birth.
Results
Nineteen ELBWI (23.2%) experienced severe hypophosphatemia. The supplementation of phosphorus was started significantly later in the hypophosphatemia group compared to that in the control group (P=0.036). Small for gestational age infants (SGAI) (P=0.006) and bronchopulmonary dysplasia (P=0.016) were more prevalent in the hypophosphatemia group compared to that in the control group.
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Fig. 2
The serum phosphate and calcium levels during the first week after birth are shown for the hypophosphate mia and control groups. (A) Mean phosphate levels during the first week after birth: there was no group difference in phosphate level on day 1, but there were significant group differences on day 2 (3.5±1.9 vs. 4.6±1.34 mg/dL, P=0.015), day 4 (1.9 [1.8; 2.2] vs. 3.5 [2.9; 4.3] mg/dL, P<0.001), day 5 (2.0±10.6 vs. 3.8±1.0 mg/dL, P<0.001), and day 7 (2.5±1.2 vs. 3.8±1.0 mg/dL, P<0.001). (B) Mean calcium levels during the first week after birth: on day 5 (10.0 [9.7; 10.8] vs. 9.2 [8.6; 9.9] mg/dL, P=0.012), there was a significant group difference in calcium levels.
![pn-29-13f2.tif](/upload/SynapseXML/1044pn/thumb/pn-29-13f2.gif)
Fig. 3
The supplementation of amino acid, phosphorus, and fluid during the first week after birth is shown for the hypophosphatemia and control groups. (A) Amino acids supplementation during the first week after birth: there was no group difference in the amount of amino acid administration during the first week after birth. (B) Phosphorus supplementation during the first week after birth: there were significant group differences in the amount of phosphorus administered on day 4 (0.0 [0.0; 0.5] vs. 0.6 [0.0; 1.0] mmol/kg/day, P=0.37) and day 5 (0.5 [0.0; 1.0] vs. 1.0 [0.8; 1.0] mmol/kg/day, P=0.017). (C) Fluid supplementation during the first week after birth: there was no group difference in the amount of fluid administration.
![pn-29-13f3.tif](/upload/SynapseXML/1044pn/thumb/pn-29-13f3.gif)
Table 1.
Patient Characteristics
Table 2.
Clinical Outcomes in the Neonatal Intensive Care Unit