Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Stoltz Sjöström, Elisabeth, DocentORCID iD iconorcid.org/0000-0002-4649-0653
Publications (10 of 47) Show all publications
Zamir, I., Stoltz Sjöström, E., van den Berg, J., Berhan, Y., Naumburg, E. & Domellöf, M. (2024). Glucose disturbances in very low-birthweight infants: results from the prospective LIGHT study. Acta Paediatrica, 113(12), 2493-2685
Open this publication in new window or tab >>Glucose disturbances in very low-birthweight infants: results from the prospective LIGHT study
Show others...
2024 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 113, no 12, p. 2493-2685Article in journal (Refereed) Published
Abstract [en]

Aim: To describe glucose homeostasis disturbances (dysglycaemia) in very low-birthweight infants (<1500 g) during the admission period and explore associated risk factors.

Methods: The LIGHT (very low-birthweight infants - glucose and hormonal profile over time) study was a prospective observational cohort study that included 49 very low-birthweight infants admitted to the tertiary neonatal intensive care unit in Umeå, Sweden, during 2016–2019. All glucose concentrations (n = 3515) sampled during the admission period were registered.

Results: Hyperglycaemia >10 mmol/L and hypoglycaemia <2.6 mmol/L were registered in 63% and 55% of the infants, respectively. Onset of dysglycaemia occurred almost exclusively in the first postnatal week. Hyperglycaemia followed 15% of corticosteroid doses given; all were preceded by pre-existing hyperglycaemia. Pre-existing hyperglycaemia was found in 66.7% of hyperglycaemic infants who received inotrope treatment. Upon commencement, 72.5% of antimicrobial treatments given were neither preceded nor followed by hyperglycaemia.

Conclusion: Dysglycaemia was common in very low-birthweight infants. Daily means of glucose concentrations seemed to follow a postmenstrual age-dependent pattern, decreasing towards term age suggesting a postmenstrual age-dependent developmental mechanism. The primary mechanism causing hyperglycaemia was independent of sepsis, and corticosteroid and inotrope treatments. No hypoglycaemia was registered during ongoing insulin treatment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
corticosteroids, hyperglycaemia, hypoglycaemia, sepsis, very low birthweight
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-228274 (URN)10.1111/apa.17370 (DOI)001282268400001 ()39087626 (PubMedID)2-s2.0-85200142030 (Scopus ID)
Funder
Samariten foundation for paediatric research, 2016- 0221Samariten foundation for paediatric research, 2017- 0275Samariten foundation for paediatric research, 2018- 0450Västerbotten County Council, RV-832421Västerbotten County Council, RV-930256
Available from: 2024-08-12 Created: 2024-08-12 Last updated: 2024-12-18Bibliographically approved
Dušek, J., Stoltz Sjöström, E. & Nilsson Zamir, I. (2024). Implementation of nutritional care bundle is associated with improved growth in preterm infants born before 32 gestational weeks. Early Human Development, 199, Article ID 106151.
Open this publication in new window or tab >>Implementation of nutritional care bundle is associated with improved growth in preterm infants born before 32 gestational weeks
2024 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 199, article id 106151Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate whether implementing a nutritional care bundle is associated with growth and morbidity in very preterm (VPT) infants.

Study design: This study compared 87 VPT infants (<32 gestational weeks) born 2018 (Before group) with 75 infants born 2020 (After group), treated at a single center in the Czech Republic. A nutritional care bundle was implemented during 2019.

Results: Median gestational age (weeks) was 30.0 [IQR 27.6-31.1] for the Before group and 29.9 [IQR 27.9-30.6] for the After group. During postnatal days 1-14, parenteral fluid intake was significantly lower in the After group compared to the Before group and conversely for enteral fluid intake. Infants in the After group achieved full enteral feeds by postnatal day 14 (72.9 % vs. Before group 51.9 %). Weight z-scores decreased significantly less from birth to 36 weeks postmenstrual age in the After group (-0.8 [IQR -1.3 to -0.5]) compared to the Before group (-1.5 [IQR -2.0 to -1.2]). Head circumference z-scores decreased significantly less in the After group (-0.8±0.9) than the Before group (-1.6±1.1). Decreased rate of patent ductus arteriosus (PDA) requiring treatment was observed in the After group (P < 0.001).

Conclusions: Implementation of a nutritional care bundle in VPT infants was associated with improved postnatal growth and may reduce treatment-requiring PDA.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Parenteral nutrition, Patent ductus arteriosus, Preterm, Weight change
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-231817 (URN)10.1016/j.earlhumdev.2024.106151 (DOI)001358315100001 ()39536633 (PubMedID)2-s2.0-85208665248 (Scopus ID)
Available from: 2024-11-15 Created: 2024-11-15 Last updated: 2025-04-24Bibliographically approved
Alm, S., Lundström, J., Stoltz Sjöström, E. & Domellöf, M. (2024). Increased enteral lipid supplementation is not associated with weight gain in extremely preterm infants with sufficient energy intake. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 79(6), 1209-1215
Open this publication in new window or tab >>Increased enteral lipid supplementation is not associated with weight gain in extremely preterm infants with sufficient energy intake
2024 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 79, no 6, p. 1209-1215Article in journal (Refereed) Published
Abstract [en]

Objectives: Practices for fortifying human milk vary among neonatal intensive care units (NICUs). It is unclear whether enteral energy intake above 140 kcal/kg/day with increased fat supplementation, leads to greater weight gain in breast milk fed extremely preterm infants (EPT).

Methods: Anthropometric and nutritional data were collected from clinical records for Swedish EPT infants born between gestational weeks 26+0 and 27+6. Included infants were treated at NICU A (n=17) or NICU B (n=39). The primary outcome was change in standard deviation scores (ΔSDS) for weight between postmenstrual weeks 29+0 and 34+0.

Results: At birth, the mean gestational age was 26.9 (±0.45 SD) weeks, and the mean birthweight was 969 (±107 SD) grams. Between postmenstrual weeks 29+0 and 33+6, the energy intake was significantly higher at NICU B: mean (SD) 149 (±14.9) vs 132 (±11.2) kcal/kg/day, p=<0.001. This was driven by a higher fat intake at NICU B: mean (SD) 7.97 (±1.05) vs 6.20 (±0.92) grams/kg/day, p=<0.001, which in turn was explained by more liberal use of lipid supplements at NICU B. No significant differences were found in ΔSDS for weight, length, or head circumference between the two NICUs.

Conclusions: Despite considerable differences in energy intake due to the use of enteral lipid supplements, our study showed no differences in ΔSDS for weight, length, or head circumference. This may be due to limited fat absorption in infants already receiving adequate energy and fat, and poor absorption of fat from human donor milk. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
Breast milk, Enteral nutrition, Growth, Human milk fortification
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-229536 (URN)10.1002/jpn3.12371 (DOI)001311144100001 ()39264030 (PubMedID)2-s2.0-85204113763 (Scopus ID)
Funder
Swedish Research Council, 2023-01784
Available from: 2024-09-12 Created: 2024-09-12 Last updated: 2025-01-12Bibliographically approved
Zamir, I., Stoltz Sjöström, E., van den Berg, J., Naumburg, E. & Domellöf, M. (2024). Insulin resistance prior to term age in very low birthweight infants: a prospective study. BMJ Paediatrics Open, 8(1), Article ID e002470.
Open this publication in new window or tab >>Insulin resistance prior to term age in very low birthweight infants: a prospective study
Show others...
2024 (English)In: BMJ Paediatrics Open, E-ISSN 2399-9772, Vol. 8, no 1, article id e002470Article in journal (Refereed) Published
Abstract [en]

Objective: To explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period.

Design: A prospective observational study—the Very Low Birth Weight Infants, Glucose and Hormonal Profiles over Time study.

Setting: A tertiary neonatal intensive care unit and four neonatal units in county hospitals in Sweden.

Patients: 48 infants born <1500 g (VLBW) during 2016–2019.

Outcome measures: Plasma concentrations of glucose-related hormones and proteins (C-peptide, insulin, ghrelin, glucagon-like peptide 1 (GLP-1), glucagon, leptin, resistin and proinsulin), insulin:C-peptide and proinsulin:insulin ratios, Homoeostatic Model Assessment 2 (HOMA2) and Quantitative Insulin Sensitivity Check (QUICKI) indices, measured on day of life (DOL) 7 and at postmenstrual age 36 weeks.

Results: Lower gestational age was significantly associated with higher glucose, C-peptide, insulin, proinsulin, leptin, ghrelin, resistin and GLP-1 concentrations, increased HOMA2 index, and decreased QUICKI index and proinsulin:insulin ratio. Hyperglycaemic infants had significantly higher glucose, C-peptide, insulin, leptin and proinsulin concentrations, and lower QUICKI index, than normoglycaemic infants. Higher glucose and proinsulin concentrations and insulin:C-peptide ratio, and lower QUICKI index on DOL 7 were significantly associated with longer duration of hyperglycaemia during the admission period.

Conclusions: VLBW infants seem to have a hormone profile consistent with insulin resistance. Lower gestational age and hyperglycaemia are associated with higher concentrations of insulin resistance markers.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-220760 (URN)10.1136/bmjpo-2023-002470 (DOI)001177387800002 ()2-s2.0-85184815394 (Scopus ID)
Funder
Umeå UniversityRegion Västerbotten, RV-832421Region Västerbotten, RV-930256Samariten foundation for paediatric research, 2016-0221Samariten foundation for paediatric research, 2017-0275Samariten foundation for paediatric research, 2018-0450
Available from: 2024-02-12 Created: 2024-02-12 Last updated: 2025-04-24Bibliographically approved
Söderquist Kruth, S., Westin, V., Hallberg, B., Brindefalk, B., Stoltz Sjöström, E. & Rakow, A. (2024). Neonatal nutrition and early childhood body composition in infants born extremely preterm. Clinical Nutrition ESPEN, 63, 727-735
Open this publication in new window or tab >>Neonatal nutrition and early childhood body composition in infants born extremely preterm
Show others...
2024 (English)In: Clinical Nutrition ESPEN, E-ISSN 2405-4577, Vol. 63, p. 727-735Article in journal (Refereed) Published
Abstract [en]

Background & aims: Previous studies have observed changes in fat and fat-free mass among preterm infants when compared to term-born infants. However, these studies have mainly focused on moderate or very preterm infants, with a scope limited to the first few years of life. We aimed to compare body composition in extremely preterm infants to term-born infants in early childhood. Additionally, we investigated whether early neonatal nutrition was associated with the distribution of fat- and fat-free mass in later life.

Methods: The study used dual-energy x-ray absorptiometry to evaluate the body composition of 52 children aged 6–9-years, of whom 35 were born extremely preterm and 17 were born at term and was analyzed using multivariate linear regression. Nutritional intakes of fluids, energy, and macronutrients during the first eight postnatal weeks for 26 extremely preterm infants were investigated in relation to body composition at age 6–9 years using Bayesian regression analysis and Gradient Boosting Machine.

Results: Children born extremely preterm had smaller head circumference (confidence interval −8.7 to −1.7), shorter height (confidence interval −2.7 to −0.6), higher waist to height ratio (confidence interval 0.01–0.05) and lower fat-free mass (confidence interval −3.9 to −0.49), compared to children born at full-term. Children born extremely preterm had a differing response to amount of fluid and macronutrient intake for both fat mass index and fat-free mass index. A bimodal response showed high intake of fluid and macronutrients as associated with high fat mass index for some children, whereas others demonstrated an inverse association, suggesting analysis on cohort-level as problematic.

Conclusions: Childhood body composition differs between extremely preterm infants and term-born infants. Extremely preterm infants display differing responses in their body composition to varying levels of fluids and macronutrient intake during the neonatal period.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Body composition, Extreme prematurity, Fat mass, Fat-free mass, Neonatal nutrition
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-228766 (URN)10.1016/j.clnesp.2024.08.002 (DOI)001299284200001 ()39154805 (PubMedID)2-s2.0-85201365724 (Scopus ID)
Available from: 2024-08-22 Created: 2024-08-22 Last updated: 2024-09-19Bibliographically approved
Söderquist Kruth, S., Willers, C., Persad, E., Stoltz Sjöström, E., Rautiainen Lagerström, S. & Rakow, A. (2024). Probiotic supplementation and risk of necrotizing enterocolitis and mortality among extremely preterm infants - the Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial: study protocol for a multicenter, double-blinded, placebo-controlled, and registry-based randomized controlled trial. Trials, 25(1), Article ID 259.
Open this publication in new window or tab >>Probiotic supplementation and risk of necrotizing enterocolitis and mortality among extremely preterm infants - the Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial: study protocol for a multicenter, double-blinded, placebo-controlled, and registry-based randomized controlled trial
Show others...
2024 (English)In: Trials, E-ISSN 1745-6215, Vol. 25, no 1, article id 259Article in journal (Refereed) Published
Abstract [en]

Background: Extremely preterm infants, defined as those born before 28 weeks’ gestational age, are a very vulnerable patient group at high risk for adverse outcomes, such as necrotizing enterocolitis and death. Necrotizing enterocolitis is an inflammatory gastrointestinal disease with high incidence in this cohort and has severe implications on morbidity and mortality. Previous randomized controlled trials have shown reduced incidence of necrotizing enterocolitis among older preterm infants following probiotic supplementation. However, these trials were underpowered for extremely preterm infants, rendering evidence for probiotic supplementation in this population insufficient to date.

Methods: The Probiotics in Extreme Prematurity in Scandinavia (PEPS) trial is a multicenter, double-blinded, placebo-controlled and registry-based randomized controlled trial conducted among extremely preterm infants (n = 1620) born at six tertiary neonatal units in Sweden and four units in Denmark. Enrolled infants will be allocated to receive either probiotic supplementation with ProPrems® (Bifidobacterium infantis, Bifidobacterium lactis, and Streptococcus thermophilus) diluted in 3 mL breastmilk or placebo (0.5 g maltodextrin powder) diluted in 3 mL breastmilk per day until gestational week 34. The primary composite outcome is incidence of necrotizing enterocolitis and/or mortality. Secondary outcomes include incidence of late-onset sepsis, length of hospitalization, use of antibiotics, feeding tolerance, growth, and body composition at age of full-term and 3 months corrected age after hospital discharge.

Discussion: Current recommendations for probiotic supplementation in Sweden and Denmark do not include extremely preterm infants due to lack of evidence in this population. However, this young subgroup is notably the most at risk for experiencing adverse outcomes. This trial aims to investigate the effects of probiotic supplementation on necrotizing enterocolitis, death, and other relevant outcomes to provide sufficiently powered, high-quality evidence to inform probiotic supplementation guidelines in this population. The results could have implications for clinical practice both in Sweden and Denmark and worldwide.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-223442 (URN)10.1186/s13063-024-08088-8 (DOI)001202031200002 ()2-s2.0-85190306127 (Scopus ID)
Funder
Karolinska InstituteSwedish Research CouncilStiftelsen drottning Silvias jubileumsfondH.R.H. Crown Princess Lovisa's Association for Child CareFöreningen Mjölkdroppens stiftelseSamariten foundation for paediatric research
Available from: 2024-04-16 Created: 2024-04-16 Last updated: 2025-04-24Bibliographically approved
Alm, S., Stoltz Sjöström, E. & Domellöf, M. (2023). Prevalence and risk factors for post discharge feeding problems in children born extremely preterm. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 76(4), 498-504
Open this publication in new window or tab >>Prevalence and risk factors for post discharge feeding problems in children born extremely preterm
2023 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 76, no 4, p. 498-504Article in journal (Refereed) Published
Abstract [en]

Objectives: Preterm infants have a high risk of post discharge feeding problems, but there is a lack of population-based studies in infants born extremely preterm and little is known about underlying mechanisms.The objectives were to assess the incidence of post discharge feeding problems and underweight in a population-based cohort of infants born extremely preterm in Sweden (EXPRESS) and identify perinatal risk factors.

Methods: Perinatal health data and prenatal/postnatal growth data was prospectively collected in the cohort. Data on clinical diagnoses related to feeding problems were obtained from the Swedish Patient Register, population prevalence data was also obtained. The main outcome was a composite of post discharge feeding problem diagnosis and/or underweight at 2.5 years of age.

Results: In total, 66 children (19%) had post discharge feeding problems diagnosed before 2 years and/or underweight at 2.5 years of age. The risk of feeding problems when compared to the general population was significantly higher, with an odds ratio (OR) of 193 (95% CI 137.6-270.9). The strongest risk factors for feeding problems were the number of days on mechanical ventilation during the first eight postnatal weeks, OR of 1.59 (CI 95% 1.29-1.98), and the Clinical Risk Index for Babies-score, OR of 1.14 (CI 95% 1.03-1.26).

Conclusions: Post discharge feeding problems and underweight are common in children born extremely preterm. The strongest perinatal risk factor for later feeding problems was early treatment with mechanical ventilation. Identifying infants at risk of post discharge feeding problems might be useful for targeting of nutritional support.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-205895 (URN)10.1097/mpg.0000000000003704 (DOI)000957196200024 ()36652562 (PubMedID)2-s2.0-85151043409 (Scopus ID)
Funder
Swedish Research Council, 2016-02095Swedish Research Council, 2019-01005
Available from: 2023-03-22 Created: 2023-03-22 Last updated: 2024-09-12Bibliographically approved
Gialamas, S., Stoltz Sjöström, E., Diderholm, B., Domellöf, M. & Ahlsson, F. (2022). Amino acid infusions in umbilical artery catheters enhance protein administration in infants born at extremely low gestational age. Acta Paediatrica, 111(3), 536-545
Open this publication in new window or tab >>Amino acid infusions in umbilical artery catheters enhance protein administration in infants born at extremely low gestational age
Show others...
2022 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 111, no 3, p. 536-545Article in journal (Refereed) Published
Abstract [en]

AIM: It is challenging to provide extremely low gestational age neonates (ELGANs) with adequate protein supply. This study aimed to investigate whether amino acid (AA) infusion in the umbilical artery catheter (UAC) in ELGANs is safe and enhances protein supply and growth.

METHOD: A before and after study including infants born <27 weeks, treated in Uppsala, Sweden, during 2004-2007, compared those receiving normal saline/10% dextrose in water with those receiving AA infusion in the UAC. Data were retrieved from the Extremely Preterm Infants in Sweden Study, hospital records and the Swedish Neonatal Quality Register. Group comparisons, univariate and multivariate analyses were conducted.

RESULTS: AA group (n = 41, females 39%) received on average approximately 0.3 g/kg/day more protein during the first postnatal week, compared to control group (n = 30, females 40%) (unstandardised coefficient (B) 0.26, p .001) but no difference was noted during 8-28 postnatal days. The type of infusion was not associated with growth variables. The incidence of neonatal morbidities and UAC-related thrombosis did not differ between the groups.

CONCLUSION: AA infusions in the UACs in ELGANs is safe and enhances protein supply during the first postnatal week. However, this practice is not associated with growth during the first 28 postnatal days.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
amino acids, extremely low gestational age, growth, protein intake, umbilical artery catheter
National Category
Clinical Medicine
Research subject
Pediatrics
Identifiers
urn:nbn:se:umu:diva-190201 (URN)10.1111/apa.16196 (DOI)000726707200001 ()34822182 (PubMedID)2-s2.0-85120465879 (Scopus ID)
Available from: 2021-12-09 Created: 2021-12-09 Last updated: 2023-03-24Bibliographically approved
Rodebjer Cairns, S. & Stoltz Sjöström, E. (2022). Dietitians’ perspectives on challenges and prospects for group-based education to adults with type 1 diabetes: a qualitative study. BMC Endocrine Disorders, 22(1), Article ID 249.
Open this publication in new window or tab >>Dietitians’ perspectives on challenges and prospects for group-based education to adults with type 1 diabetes: a qualitative study
2022 (English)In: BMC Endocrine Disorders, E-ISSN 1472-6823, Vol. 22, no 1, article id 249Article in journal (Refereed) Published
Abstract [en]

Background: Type 1 diabetes (T1DM) is an autoimmune disorder which can have short- and long-term adverse effects on health. Dietitians in diabetes offer specialist evidence-based advice to people with T1DM and provide education in either individual or group settings. The purpose of this study was to explore dietitians’ perception of, and role in, group-based education as well as prospects for development. 

Methods: This was a qualitative descriptive study conducted in Sweden using a convenience sampling of dietitians working in adult diabetes care. Semi-structured interviews were conducted with participants and data were analysed using a content analysis approach.  

Results: Ten dietitians with a median experience of 14.5 years in diabetes care were interviewed. The informants were all appreciative of facilitating group-based education and perceived that it was beneficial for people with T1DM to be part of group processes, but the informants did also suggest that there were challenges for their professional role. The main challenges reported was to adjust the level of depth and complexity to the information provided and the lack of ability to individualize the education-sessions in a heterogenous group. None of the dietitians reported performing pre-assessment or follow-up audits on the group-based education. 

Conclusions: There was a great engagement from the dietitians, but they identified a lack of framework that address challenges regarding group-based education. The dietitians experienced examples of person-centred care while facilitating group-based education, which may benefit people with T1DM. Based on the results, it would be valuable to explore the pedagogic training level of Swedish dietitians and potential barriers in their ability to facilitate group-based education. We suggest that a framework for group-based education should be explored together with patient representatives to optimize the care given to ensure cost-effectiveness, optimize clinical outcomes, quality of life and equally accessible care for people with T1DM. 

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Dietitians, group-based education, national diabetes guidelines, structured education, Type 1 Diabetes Mellitus, person-centred care
National Category
Nutrition and Dietetics
Research subject
health services research
Identifiers
urn:nbn:se:umu:diva-199979 (URN)10.1186/s12902-022-01165-6 (DOI)000869242500002 ()36253850 (PubMedID)2-s2.0-85139999363 (Scopus ID)
Available from: 2022-10-04 Created: 2022-10-04 Last updated: 2025-02-11Bibliographically approved
Späth, C., Stoltz Sjöström, E. & Domellöf, M. (2022). Higher Parenteral Electrolyte Intakes in Preterm Infants During First Week of Life: Effects on Electrolyte Imbalances. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 75(3), E53-E59
Open this publication in new window or tab >>Higher Parenteral Electrolyte Intakes in Preterm Infants During First Week of Life: Effects on Electrolyte Imbalances
2022 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 75, no 3, p. E53-E59Article in journal (Refereed) Published
Abstract [en]

Objectives: This study aimed to investigate the effects of a higher intake of electrolytes from parenteral nutrition (PN) on plasma electrolyte concentrations in very low birth weight (VLBW, <1500 g) infants.

Methods: This was a single-center cohort study including all VLBW infants born before (n = 81) and after (n = 53) the implementation of a concentrated PN regimen. Daily nutritional intakes and plasma concentrations of sodium, chloride, potassium, phosphate, and calcium were collected from clinical charts.

Results: During the first postnatal week, electrolyte intakes were higher in infants who received concentrated PN compared with infants who received original PN. Infants who received concentrated PN had a lower incidence of hypokalemia (<3.5 mmol/L; 30% vs 76%, P < 0.001) and severe hypophosphatemia (<1.0 mmol/L; 2.2% vs 17%, P = 0.02). While the relatively high prevalence of severe hypophosphatemia in infants who received original PN can be explained by a phosphorus intake below the recommendation, the potassium intake during the first 3 postnatal days (mean ± SD: 0.7 ± 0.2 mmol/kg/d) was within the recommendation. The prevalence of early hypernatremia was not affected by the different sodium intake in the 2 groups.

Conclusions: In VLBW infants, a sodium-containing PN solution (about 2.7 mmol/100 mL) does not cause hypernatremia during the first days of life. Furthermore, providing at least 1 mmol potassium/kg/d during the first 3 postnatal days might be necessary to prevent early hypokalemia.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022
Keywords
chloride, hypernatremia, hypokalemia, potassium, preterm infants, sodium
National Category
Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-199394 (URN)10.1097/MPG.0000000000003532 (DOI)000841921200005 ()35726971 (PubMedID)2-s2.0-85137009137 (Scopus ID)
Available from: 2022-09-28 Created: 2022-09-28 Last updated: 2025-02-11Bibliographically approved
Projects
InSyNC – Integrating Sustainability in Nutrition Care National Doctoral Programme [2022-06295_VR]; Uppsala University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4649-0653

Search in DiVA

Show all publications