Observational studyPloS one2013
Initial amino acid intake influences phosphorus and calcium homeostasis in preterm infants--it is time to change the composition of the early parenteral nutrition.
Observational study in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- Early versus late administration of amino acids in preterm infants receiving parenteral nutrition.The Cochrane database of systematic reviews · 2024Pooled it
- Higher versus lower protein intake in formula-fed low birth weight infants.The Cochrane database of systematic reviews · 2020Pooled it
- Serum Magnesium Levels in Preterm Infants Are Higher Than Adult Levels: A Systematic Literature Review and Meta-Analysis.Nutrients · 2017Pooled it
- Neurodevelopmental Outcome in Very Preterm Infants Randomised to Receive Two Different Standardised, Concentrated Parenteral Nutrition Regimens.Nutrients · 2023Trial
- Trial
- Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants.Nutrients · 2016Trial
- Urinary metabolite profiles in premature infants show early postnatal metabolic adaptation and maturation.Nutrients · 2014Trial
- Neonatal refeeding syndrome and postnatal growth in extremely low birth weight infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Identifying a Safety Threshold for Parenteral Glucose Intake in the Early Acute Phase of Preterm Neonates.Nutrients · 2026Article
- Refeeding Syndrome May Increase the Risk of Anemia of Prematurity: Is Early Enteral Nutrition the Solution?Nutrients · 2026Observational
- Gastrointestinal Tolerance and Refeeding Syndrome in Severely Malnourished Children Treated with Oral Nutrition Supplements Compared to F-75/F-100: A Hospital-Based Randomized Controlled Pilot Trial.Pediatric gastroenterology, hepatology & nutrition · 2026Article
- Predicting serum phosphate levels in very preterm infants using machine learning.Frontiers in pediatrics · 2026Article
- The Relationship Between Refeeding Syndrome and Preterm Morbidities in Preterm Infants.Children (Basel, Switzerland) · 2025Article
- Risk Factors for Early Neonatal Hypocalcemia in Preterm Neonates Born After 32 Weeks Gestation.Children (Basel, Switzerland) · 2025Article
- Controversies in Parenteral Protein Intake in Preterm Infants.Children (Basel, Switzerland) · 2025Review
- Association between early phosphate intake and refeeding syndrome in extremely low-birth-weight infants: A retrospective cohort study.JPEN. Journal of parenteral and enteral nutrition · 2025Article
- Article
- "Calcium-Phosphorus-MagnesiumNutrients · 2025Observational
- Protein intakes for preterm infants, and the need for a multi-nutrient holistic approach.Pediatric research · 2025Article
- Impact of Refeeding Syndrome on the Short-Term Clinical Outcomes of Very-Premature Infants.Nutrients · 2024Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly aggressive parenteral nutrition (PN), consisting of caloric and nitrogen intake soon after birth, is currently proposed for the premature baby. Some electrolyte disturbances, such as hypophosphatemia and hypercalcemia, considered unusual in early life, were recently described while using this PN approach. We hypothesize that, due to its impact on cell metabolism, the initial amino acid (AA) amount may specifically influence the metabolism of phosphorus, and consequently of calcium. We aim to evaluate the influence of AA intake on calcium-phosphorus metabolism, and to create a calculation tool to estimate phosphorus needs.
methodsProspective observational study. Phosphate and calcium plasma concentrations and calcium balance were evaluated daily during the first week of life in very preterm infants, and their relationship with nutrition was studied. For this purpose, infants were divided into three groups: high, medium and low AA intake (HAA, MAA, LAA). A calculation formula to assess phosphorus needs was elaborated, with a theoretical model based on AA and calcium intake, and the cumulative deficit of phosphate intake was estimated.
results154 infants were included. Hypophosphatemia (12.5%) and hypercalcemia (9.8%) were more frequent in the HAA than in the MAA (4.6% and 4.8%) and in the LAA group (0% and 1.9%); both p<0.001. DISCUSSION: Calcium-phosphorus homeostasis was influenced by the early AA intake. We propose to consider phosphorus and calcium imbalances as being part of a syndrome, related to incomplete provision of nutrients after the abrupt discontinuation of the placental nutrition at birth (PI-ReFeeding syndrome). We provide a simple tool to calculate the optimal phosphate intake. The early introduction of AA in the PN soon after birth might be completed by an early intake of phosphorus, since AA and phosphorus are (along with potassium) the main determinants of cellular growth.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.