133 - The impact of refeeding syndrome on neonatal outcome of very premature infants

Poster Number: 133
Publication Number: 133.589

Background: Early parenteral nutrition remains the golden route of care in preterm infants and the main early source of energy in the first days of life. Giving adequate amino acid to very preterm infants during the early postnatal period is critical to make sure proper growth and avoid early postnatal malnutrition. Amino acid and energy intake may cause refeeding syndrome (hypophosphatemia, hypercalcemia).

Objective: The aim of this study is to investigate the impact of refeeding syndrome on growth velocity, major neonatal outcomes, and preterm infants’ mortality.

Design/Methods: This study included very preterm infants who were born at King Saud Medical City, a tertiary referral center, at ≤32 weeks of gestation, had a birth weight of < 1500 g, received parenteral nutrition immediately after birth and admitted to a level 3 neonatal intensive care unit between January 2015 and Augest 2023. Modified log-Poisson regression with generalized linear models and a robust variance estimator (Huber–White) were used to adjust for potential confounding factors.

Results: A total of 760 infants met our inclusion criteria. Of them, 289 (38%) developed refeeding syndrome. Infants with refeeding syndrome had lower discharge weight compared with infants without refeeding syndrome (adjusted mean difference (aMD) 0.93; 95% CI 0.87, 0.99). Intraventricular hemorrhage and mortality were significantly higher in infants with refeeding syndrome (adjusted relative risk (aRR) 1.59; 95% CI 1.31, 1.94, aRR 1.74; 95% CI 1.37; 2.21; respectively).

Conclusion(s): Neonatal refeeding syndrome is common in very premature infants and is associated with lower growth velocity and increased neonatal morbidity and mortality.