Incidence and Risk Factors of Refeeding Syndrome in Preterm Infants

• Published in: Nutrients 2024-08, Vol.16 (15), p.2557
• Main Authors: Asfour, Suzan S, Alshaikh, Belal, Mathew, Maya, Fouda, Dina I, Al-Mouqdad, Mountasser M
• Format: Article
• Language: English
• Subjects: Amino acids; Apgar score; Birth weight; Congenital diseases; Electrolytes; Enteral nutrition; Female; Gestational Age; hemorrhage; Humans; Hypercalcemia; Hypertension; Incidence; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - epidemiology; Infant, Premature, Diseases - etiology; Infants (Premature); Intensive Care Units, Neonatal - statistics & numerical data; Lipids; Male; males; Malnutrition; Metabolism; Mortality; Neonatal intensive care; Newborn babies; Nutrition; parenteral feeding; Parenteral nutrition; Parenteral Nutrition - adverse effects; Pediatrics; Phosphates; Phosphates - blood; Potassium; Premature babies; Refeeding Syndrome - epidemiology; Refeeding Syndrome - etiology; regression analysis; relative risk; Retrospective Studies; Risk assessment; Risk Factors; Sodium; sodium phosphate; Starvation; Steroids; Surfactants; variance
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16152557

This study aimed to evaluate the incidence and risk factors associated with refeeding syndrome (RFS) in preterm infants (≤32 weeks gestational age) during their first week of life. Infants (gestational age ≤ 32 weeks; birth weight < 1500 g) who were admitted to the neonatal intensive care unit (NICU), level III, and received parenteral nutrition between January 2015 and April 2024 were retrospectively evaluated. Modified log-Poisson regression with generalized linear models and a robust variance estimator was applied to adjust the relative risk of risk factors. Of the 760 infants identified, 289 (38%) developed RFS. In the multivariable regression analysis, male, intraventricular hemorrhage (IVH), and sodium phosphate significantly affected RFS. Male infants had significantly increased RFS risk (aRR1.31; 95% CI 1.08-1.59). The RFS risk was significantly higher in infants with IVH (aRR 1.71; 95% CI 1.27-2.13). However, infants who received higher sodium phosphate in their first week of life had significantly lower RFS risk (aRR 0.67; 95% 0.47-0.98). This study revealed a notable incidence of RFS among preterm infants aged ≤32 gestational weeks, with sex, IVH, and low sodium phosphate as significant risk factors. Refined RFS diagnostic criteria and targeted interventions are needed for optimal management.