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Refeeding syndrome in very-low-birth-weight intrauterine growth-restricted neonates

J R Ross1, C Finch, M Ebeling

  • 1Division of Neonatology, Department of Pediatrics, Medical University of South Carolina Children's Hospital, Charleston, SC 29425, USA. rossjr@musc.edu

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 30, 2013
PubMed

Insights

Refeeding syndrome, characterized by low phosphorus, is more common in very-low-birth-weight (VLBW) infants with intrauterine growth restriction (IUGR), especially those born to mothers with preeclampsia. Close electrolyte monitoring is crucial for these infants.

Area of Science:

  • Neonatalogy
  • Pediatric Endocrinology
  • Critical Care Medicine

Background:

  • Refeeding syndrome is a potentially fatal complication in malnourished patients.
  • Very-low-birth-weight (VLBW) infants, particularly those with intrauterine growth restriction (IUGR), are at high risk.
  • Maternal preeclampsia is a known risk factor for adverse neonatal outcomes.

Purpose of the Study:

  • To determine the incidence of refeeding syndrome in VLBW infants with IUGR.
  • To compare the incidence of hypophosphatemia in VLBW infants with and without IUGR.
  • To investigate the association between maternal preeclampsia and refeeding syndrome in VLBW infants.

Main Methods:

  • Retrospective cohort study of VLBW infants over a 10-year period.
  • Evaluation of electrolyte abnormalities, specifically hypophosphatemia, in the first postnatal week.
  • Comparison of infants with IUGR (n=271) and without IUGR (n=1982).

Main Results:

  • IUGR infants had significantly higher rates of hypophosphatemia (41% vs 8.9%) and severe hypophosphatemia (11.4% vs 1%).
  • The relative risk of hypophosphatemia in IUGR infants was 7.25.
  • Maternal preeclampsia was significantly associated with hypophosphatemia in all VLBW infants (OR: 2.58).

Conclusions:

  • Refeeding syndrome is prevalent in VLBW infants with IUGR, especially those born to mothers with preeclampsia.
  • Close monitoring of electrolytes, particularly phosphorus, is essential in this vulnerable population.
  • Early identification and management of refeeding syndrome can improve outcomes for high-risk VLBW infants.
Abstract

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