Neonatal Med.  2019 Aug;26(3):155-161. 10.5385/nm.2019.26.3.155.

Effects of Early Phosphorus Intake on Respiratory Distress in Extremely Low-Birth-Weight Infants

• Bae HJ
• Yoon HW
• Kim MJ
• Jung AH
• Jung SH
• Hahn HJ
• Jo YH
• Cho YS
• Kim EK
• Shin SH
• Song IG
• Shin SH

• KMID: 2457183
• DOI: http://doi.org/10.5385/nm.2019.26.3.155

Abstract

PURPOSE
This study was aimed to investigate the effect of early phosphorus intake on respiratory distress in extremely low-birth-weight infants (ELBWIs) with a high incidence of hypophosphatemia.
METHODS
We performed a retrospective study to target 164 ELBWIs admitted to the neonatal intensive care unit in Seoul National University Children's Hospital. Birth characteristics, nutritional intake, and electrolyte levels during the first week were investigated as predictors that would affect the clinical outcomes. The correlations among invasive ventilation at postnatal age of 2 weeks, moderate-to-severe bronchopulmonary dysplasia (BPD), and phosphorous intake were analyzed.
RESULTS
Hypophosphatemia (phosphorus level <4 mg/dL) was observed in 72.0% of the subjects. The rates of invasive ventilation (P=0.001) and moderate-to-severe BPD (P=0.005) were significantly lower in the high phosphorus intake group (≥0.7 mM/kg/day) than in the low phosphorus intake group (<0.7 mM/kg/day). Phosphorus intake during the first week was a significant factor affecting invasive ventilation at 2 weeks of age (adjusted odds ratio [OR], 8.212; 95% confidence interval [CI], 2.256 to 28.896; P=0.001) and moderate-to-severe BPD (adjusted OR, 3.402; 95% CI, 1.274 to 9.084; P=0.015).
CONCLUSION
Early insufficient phosphorus intake confers a significantly higher risk with invasive ventilation at 2 weeks of age and moderate-to-severe BPD. Therefore, early sufficient phosphorus supply may improve respiratory outcomes in ELBWIs.

Keyword

Infant, extremely low birth weight; Phosphorus; Respiratory distress; Bronchopulmonary dysplasia

MeSH Terms

Bronchopulmonary Dysplasia
Humans
Hypophosphatemia
Incidence
Infant, Extremely Low Birth Weight
Infant, Low Birth Weight*
Infant, Newborn
Intensive Care, Neonatal
Odds Ratio
Parturition
Phosphorus*
Retrospective Studies
Seoul
Ventilation
Phosphorus

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