{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:58:12Z","timestamp":1785542292854,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,23]],"date-time":"2025-02-23T00:00:00Z","timestamp":1740268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preterm infants are at risk of refeeding syndrome, a constellation of biochemical changes associated with nutrition. We aimed to determine whether increased early phosphate intake with routine biochemical monitoring is associated with a reduction in refeeding syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study in two Auckland neonatal intensive care units comparing infants born &lt;1000\u2009g before (2014\u20132018, <jats:italic>standard phosphate intake<\/jats:italic>) and after (2020\u20132021, <jats:italic>early phosphate intake<\/jats:italic>) changes to intravenous nutrition protocols that increased phosphate intake and introduced biochemical monitoring. The <jats:italic>standard phosphate intake<\/jats:italic> cohort comprised the participants who received placebo in a randomized controlled trial of early increased amino acid intake. The <jats:italic>early phosphate intake<\/jats:italic> cohort was identified prospectively. Data were retrieved from the trial database or prospectively from electronic medical records. Groups were compared using either the chi\u2010square test or pooled <jats:italic>t<\/jats:italic> test and logistic or multiple logistic regression analysis. Refeeding syndrome was defined as concurrent hypophosphatemia (serum phosphate &lt;1.4\u2009mmol\u2009L<jats:sup>\u22121<\/jats:sup>) and hypercalcemia (serum calcium &gt;2.8\u2009mmol\u2009L<jats:sup>\u22121<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of refeeding syndrome in the first 5 days after birth decreased from 11.9% to 2.9%, hypophosphatemia from 53.5% to 21.2%, and severe hypophosphatemia (&lt;0.9\u2009mmol\u2009L<jats:sup>\u22121<\/jats:sup>) from 11.3% to 1.2%. Probable early\u2010 and late\u2010onset sepsis reduced from 51.4% to 28.2% and from 62.5% to 28.0%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased early phosphate intake with routine biochemical monitoring is associated with a lower incidence of refeeding syndrome, hypophosphatemia, and associated comorbidities. Whether these associations are causal requires further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2739","type":"journal-article","created":{"date-parts":[[2025,2,23]],"date-time":"2025-02-23T08:03:46Z","timestamp":1740297826000},"page":"460-467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association between early phosphate intake and refeeding syndrome in extremely low\u2010birth\u2010weight infants: A retrospective cohort study"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6902-3524","authenticated-orcid":false,"given":"Thomas B.","family":"Wright","sequence":"first","affiliation":[{"name":"Liggins Institute, University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6424-6577","authenticated-orcid":false,"given":"Frank H.","family":"Bloomfield","sequence":"additional","affiliation":[{"name":"Liggins Institute, University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanith","family":"Alexander","sequence":"additional","affiliation":[{"name":"Liggins Institute, University of Auckland Auckland New Zealand"},{"name":"Neonatal Unit, Kidz First, Middlemore Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2329-8287","authenticated-orcid":false,"given":"Barbara E.","family":"Cormack","sequence":"additional","affiliation":[{"name":"Liggins Institute, University of Auckland Auckland New Zealand"},{"name":"Newborn Services, Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1934"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a301"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7445.908"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(01)00542-1"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1977.03630140051013"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.2012.03590.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2011-0485"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221042"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.28"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.54"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677713"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2012.09.004"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204886"},{"key":"e_1_2_11_15_1","unstructured":"CormackB BellhouseS Newborn Sevices Clinical Practice Committee. 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