# The Relationship Between Refeeding Syndrome and Preterm Morbidities in Preterm Infants

## TL;DR

This study finds that preterm infants with respiratory distress syndrome are more likely to develop refeeding syndrome, which is linked to longer hospital stays and other complications.

## Contribution

The study identifies a novel association between refeeding syndrome and respiratory distress syndrome in preterm infants, emphasizing the need for early metabolic monitoring.

## Key findings

- Refeeding syndrome is associated with gestational immaturity, low birth weight, and respiratory distress syndrome in preterm infants.
- Infants with refeeding syndrome had prolonged hospitalization and required more frequent electrolyte monitoring.
- Early identification and electrolyte support can reduce respiratory distress in these infants.

## Abstract

What are the main findings?
The findings suggest that RFS in preterm infants is associated with gestational immaturity, low birth weight, perinatal compromise, and SGA status, and correlates with increased respiratory distres sydrome and prolonged hospitalization.With more frequent laboratory assessment of infants with RDS, the necessary electrolyte support can be provided early, thereby reducing respiratory distress in these infants.

The findings suggest that RFS in preterm infants is associated with gestational immaturity, low birth weight, perinatal compromise, and SGA status, and correlates with increased respiratory distres sydrome and prolonged hospitalization.

With more frequent laboratory assessment of infants with RDS, the necessary electrolyte support can be provided early, thereby reducing respiratory distress in these infants.

What is the implication of the main finding?
These results highlight the importance of vigilant metabolic monitoring and preventive nutritional strategies for vulnerable preterm populations.The early identification of infants at risk and the careful titration of parenteral and enteral nutrition are crucial for minimising complications and improving outcomes.

These results highlight the importance of vigilant metabolic monitoring and preventive nutritional strategies for vulnerable preterm populations.

The early identification of infants at risk and the careful titration of parenteral and enteral nutrition are crucial for minimising complications and improving outcomes.

Objective: This study was conducted to determine the risk factors for refeeding syndrome (RFS) in preterm infants and evaluate its relationship with preterm morbidities. Methods: Preterm infants born before 30 weeks of gestation were retrospectively evaluated. RFS was diagnosed as phosphorus <4 mg/dL and/or calcium >11 mg/dL on postnatal day 7. Demographic and clinical findings were compared between preterm infants with and without RFS. Results: A total of 174 infants who met the inclusion criteria were analyzed. RFS was diagnosed with 60 infants (34.5%). The mean gestational age (GA) was 27 (range, 25–28) weeks in the RFS group and 28 (range, 26–30) weeks in the non-RFS group (p = 0.038). Mean birth weight (BW) in each group was 790 (range, 630–1000) grams and 1033 (range, 800–1310) grams, respectively (p < 0.001). The RFS group had a lower rate of antenatal steroid (ANS) administration, lower APGAR, length of hospital stay, and higher rates of small for gestational age status, respiratory distress syndrome (RDS), bronchopulmonary dysplasia, and patent ductus arteriosus (p < 0.05). On postnatal day 7, the RFS group had lower phosphorus and higher calcium levels (p < 0.001). After adjustment for GA, BW, Apgar score, and ANS, the frequency of RDS was higher among infants with RFS (p < 0.05). Conclusions: Preterm infants with RDS were more likely to develop RFS. Our results suggest that these infants require more frequent laboratory testing and closer follow-up to monitor for RFS and ensure timely electrolyte support.