Hypophosphatemia in small for gestational age extremely low birth weight infants receiving parenteral nutrition in the first week after birth

Objectives: To investigate the risk of hypophosphatemia and hypercalcemia in small for gestational age (SGA) extremely low birth weight infants (ELBWI) receiving parenteral nutrition. Methods: A retrospective review of 58 ELBWI was conducted. Serum calcium (Ca) and phosphate (PO4) concentrations on days 1 and 8 after birth were examined for associations with body measurements and nutritional factors in the 1st week of life. Results: Lower birth weight standard deviation (SD) scores were correlated with hypophosphatemia and hypercalcemia in SGA ELBWI on day 8. Higher parenteral amino acid (AA) administration was correlated with hypophosphatemia on day 8. SGA ELBWI exhibited lower serum PO4 concentrations compared to appropriate for gestational age (AGA) ELBWI on day 8. Conclusions: This is the 1st study to report that parenteral nutrition, in the first 7 days after birth for the treatment of SGA ELBWI, was correlated with hypophosphatemia and hypercalcemia. It is important to determine an ideal nutrition protocol for treatment of SGA ELBWI.