[Hypophosphatemia in preterm infants: a bimodal disorder]

Area of Science:

• Neonatology
• Pediatric Nutrition
• Metabolic Disorders

Background:

• Premature infants, especially those with intrauterine growth restriction (IUGR), are susceptible to metabolic disturbances.
• Early and late hypophosphatemia are significant concerns in preterm neonates, impacting bone health and overall development.

Purpose of the Study:

• To systematically review literature on phosphorus metabolic disturbances in preterm newborns.
• To analyze the relationship between parenteral nutrition, IUGR, and metabolic alterations.
• To highlight the importance of monitoring and timely intervention for hypophosphatemia.

Main Methods:

• Systematic literature search of PubMed and Rima databases.
• Inclusion of English and Spanish articles selected by titles and abstracts.
• Review of studies on nutritional strategies and metabolic complications in preterm infants.

Main Results:

• Parenteral nutrition in preterm infants can lead to hypophosphatemia, hypercalcemia, hypomagnesemia, hypokalemia, and hyperglycemia, especially with IUGR.
• Metabolic alterations are associated with prolonged mechanical ventilation, bronchopulmonary dysplasia, and sepsis.
• Late hypophosphatemia in preterm infants is linked to metabolic bone disease and inadequate mineralization.

Conclusions:

• Timely monitoring of serum phosphorus and calcium is essential for preterm infants, particularly those on parenteral nutrition and with IUGR.
• Nutritional intake adjustments are necessary to correct hypophosphatemia and ensure adequate mineral supply.
• Regular follow-up is crucial for high-risk preterm infants to prevent and manage metabolic bone disease.