Meenu Grewal, Videesh Sombattina
A bstract Objectives: To determine the proportion of hypophosphatemia (HP) and hyperglycemia among very low birth weight (VLBW) neonates and evaluate their association with neonatal morbidity and mortality. Materials and Methods: An observational cohort study was conducted in the Neonatal Intensive Care Unit of Maulana Azad Medical College and Lok Nayak Hospital, Delhi. A total of 54 VLBW neonates with an admission weight of <1500 g and an age of ≤5 days were included. Maternal and neonatal clinical data were recorded at admission. Serial serum phosphorus and blood glucose measurements were performed during the first week of life. Neonatal outcomes assessed included intraventricular hemorrhage (IVH), necrotizing enterocolitis, late-onset sepsis (LOS), retinopathy of prematurity (ROP), bronchopulmonary dysplasia, and mortality. Statistical analysis was performed using Statistical Package for the Social Sciences, version 25.0, and a P value of <0.05 was considered statistically significant. Results: HP was observed in 38 (70.4%) neonates, whereas hyperglycemia occurred in 32 (59.3%). Hyperglycemia was significantly more frequent among hypophosphatemic neonates compared with normophosphatemic neonates (78.9% vs. 12.5%, P < 0.0001). Neonates with hyperglycemia had significantly lower APGAR scores (appearance, pulse, grimace, activity, and respiration) at 1 min ( P = 0.002) and 5 min ( P = 0.005). Mortality was significantly higher in neonates with hyperglycemia (56.25% vs. 18.18%, P = 0.010) and HP (50% vs. 18.7%, P = 0.039). Hyperglycemia showed a significant association with IVH (43.75% vs. 9.09%, P = 0.007) and LOS (59.38% vs. 18.18%, P = 0.005), whereas HP was significantly associated with ROP ( P = 0.002). Conclusion: HP and hyperglycemia were common in VLBW neonates and were associated with adverse neonatal outcomes. Early metabolic monitoring and timely management may help reduce complications and improve survival.