ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1520420
This article is part of the Research TopicCare of the extremely preterm infantView all 15 articles
Risk factors and Impact of Hypertriglyceridemia in preterm infants under 32 weeks of gestation: Optimizing Intravenous lipid emulsion infusion rates-A single center retrospective study
Provisionally accepted
- 1Pediatrics, Ajou University Hospital, Suwon, Republic of Korea
- 2Office of Biostatics, Ajou University Medical Center, Suwon, Republic of Korea
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Introduction: Intravenous lipid emulsions are essential for parenteral nutrition in preterm infants. However, hypertriglyceridemia (HTG) is a common complication that can lead to severe complications if left untreated. This study analyzed factors influencing HTG and the effects of reduced intravenous lipid emulsion dosages. Methods: A retrospective cohort study involving premature infants born at less than 32 weeks of gestation and admitted to Ajou University Hospital between 2017 and 2022 was conducted. Infants with documented triglyceride levels within the first 10 days of life were included. The risk factors for HTG and the time to normalize triglyceride levels after intravenous lipid dose reduction were evaluated. Results: HTG was diagnosed in 104 infants. Significant risk factors included lower birth weight (OR = 0.75; 95% CI, 0.66-0.85; p < 0.001), treated for patent ductus arteriosus (OR = 2.47; 95% CI, 1.30-4.69; p = 0.006), intravenous lipid emulsion intake (OR = 1.79; 95% CI, 1.25-2.55; p = 0.001), and serum glucose level (OR = 1.01; 95% CI, 1.00-1.02; p = 0.023). The average triglyceride level in the HTG group was 287.8 mg/dL, with intravenous lipid doses of 2.7 g/kg/day. Reducing intravenous lipid doses by 0.27 ± 0.46 g/kg/day shortened the triglyceride normalization time to 4.9±5.0 days and reduced the risk of retinopathy of prematurity stage 2 or higher (OR = 0.59; 95% CI, 0.40-0.88; p = 0.011). The fat overload infusion rate, which induces HTG, was 0.332 cc/kg/h (1.6 g/kg/day). Discussion: Lower birth weight, treated patent ductus arteriosus, serum glucose levels, and higher intravenous lipid levels are significant risk factors for HTG. Adjusting the lipid dose aids in triglyceride normalization and reducing severe retinopathy of prematurity risk. Careful monitoring and management of intravenous lipid emulsion infusion rates are crucial to prevent HTG.
Keywords: intravenous fat emulsions, Parenteral Nutrition, Hypertriglyceridemia, premature infants, Retinopathy of Prematurity
Received: 31 Oct 2024; Accepted: 27 May 2025.
Copyright: © 2025 Suh, Park, Park, Choi, Park and Lee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jang Hoon Lee, Pediatrics, Ajou University Hospital, Suwon, Republic of Korea
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