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Identifying a Safety Threshold for Parenteral Glucose Intake in the Early Acute Phase of Preterm Neonates

Maria Di Chiara1, Ilaria Mastropasqua1, Flavia Gloria1

  • 1Department of Maternal-Infantile and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.

Nutrients
|June 12, 2026
PubMed

Insights

Exceeding 7 g/kg/day of parenteral dextrose in preterm neonates is linked to early hyperglycemia and hypertriglyceridemia. This study suggests a potential safety threshold for glucose intake, though further research is needed for clinical guidelines.

Area of Science:

  • Neonatalogy
  • Pediatric Endocrinology
  • Clinical Nutrition

Background:

  • Parenteral glucose safety in preterm neonates is not well-established.
  • International guidelines offer recommended ranges, but specific safety thresholds require investigation.
  • Early acute phase nutrition is critical for preterm infant outcomes.

Purpose of the Study:

  • To determine if exceeding a data-driven parenteral dextrose intake threshold is associated with adverse outcomes in preterm neonates.
  • To evaluate associations with hyperglycemia, hypertriglyceridemia, metabolic acidosis, and extrauterine growth restriction (EUGR).
  • To identify a potential safety threshold for parenteral glucose administration.

Main Methods:

  • Single-center retrospective study of preterm neonates (gestational age ≤ 34 weeks and/or birth weight ≤ 1500 g).
  • Data-driven threshold identification using restricted cubic spline logistic regression.
  • Multivariable analyses adjusted for key neonatal and perinatal factors.

Main Results:

  • A parenteral dextrose intake threshold of 7 g/kg/day was identified.
  • Exceeding this threshold was independently associated with hyperglycemia (aOR 5.55) and hypertriglyceridemia (aOR 4.36).
  • No significant association was found with metabolic acidosis or EUGR.

Conclusions:

  • Parenteral dextrose intake above 7 g/kg/day is linked to early metabolic complications in preterm infants.
  • The findings suggest a potential safety threshold for parenteral glucose within recommended ranges.
  • Prospective multicenter studies are necessary to inform clinical recommendations.

Keywords:
EUGRdextroseearly acute phasehyperglycemiahypertriglyceridemiaparenteral nutritionpreterm neonate

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