Recommended Citation
Askaroglu Y, Nakamura P, Huma L, Hasan M, Gospodin S, Prazad P. Incidence and Risk Factors for Hypertriglyceridemia in Preterm Neonates With Birth Weight Less Than 1250 Grams Receiving Parenteral Lipid Emulsion: A Single Center Retrospective Study. Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Abstract
Background/Significance:
Hypertriglyceridemia (HTG) remains a significant but poorly understood complication in extremely low birth weight infants receiving intravenous lipid emulsions. While lipids are crucial for growth and development, the optimal management strategy and risk factors for HTG development remain unclear. Currently, there is no consensus on surveillance or management guidelines for optimal lipid infusion or HTG in this vulnerable population.
Purpose:
To determine the incidence of HTG (defined as triglyceride level >250 mg/dL) in infants with birth weight (BW) < 1250 grams receiving intravenous lipid emulsions and identify associated risk factors.
Methods:
Single-center retrospective study examining infants < 1250 grams BW admitted between August 2020-July 2024. Statistical analysis included ANOVA, correlation coefficients, and comparison between HTG and non-HTG groups. Significance was set at p < 0.05.
Results:
Among 155 infants analyzed, the overall HTG incidence was 28.4%. Incidence was significantly higher in lower gestational age (GA) infants (73.33% in ≤26 weeks vs 17.60% in >26 weeks) and very low BW infants (72.73% in < 750g vs 16.39% in ≥750g). Longitudinal analysis revealed that HTG infants had significantly higher initial triglyceride levels that decreased from week 1 to week 4 (249.14 to 145.33 mg/dL, overall ANOVA p=0.007; week 1 vs week 4 p=0.003), while non-HTG infants maintained stable levels throughout (127.97 to 131.04 mg/dL, p=0.541). HTG was significantly associated with lower GA (26.7 vs 28.7 weeks, p < 0.001), lower BW (794g vs 1029g, p < 0.001), and lower Apgar scores at both 1 minute (4.7 vs 5.9, p=0.002) and 5 minutes (7.2 vs 7.9, p=0.013). Correlation analyses revealed only weak associations between triglyceride levels and at-risk clinical variables, with BW showing the strongest negative correlation (r=-0.279). Maternal body mass index showed no significant difference between groups (p=0.218).
Conclusion:
This study demonstrates that preterm infants ≤26 weeks GA and < 750g BW are at highest risk for HTG development. The pattern of changing triglyceride levels and weak correlations with clinical risk factors suggest HTG is primarily related to infant maturity. These findings support the need for targeted monitoring strategies in high-risk infants, particularly during the first week of life. Future prospective studies are needed to establish optimal lipid administration protocols for these vulnerable infants and validate predictive risk factors for HTG development.
Presentation Notes
Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Incidence and Risk Factors for Hypertriglyceridemia in Preterm Neonates With Birth Weight Less Than 1250 Grams Receiving Parenteral Lipid Emulsion: A Single Center Retrospective Study
Background/Significance:
Hypertriglyceridemia (HTG) remains a significant but poorly understood complication in extremely low birth weight infants receiving intravenous lipid emulsions. While lipids are crucial for growth and development, the optimal management strategy and risk factors for HTG development remain unclear. Currently, there is no consensus on surveillance or management guidelines for optimal lipid infusion or HTG in this vulnerable population.
Purpose:
To determine the incidence of HTG (defined as triglyceride level >250 mg/dL) in infants with birth weight (BW) < 1250 grams receiving intravenous lipid emulsions and identify associated risk factors.
Methods:
Single-center retrospective study examining infants < 1250 grams BW admitted between August 2020-July 2024. Statistical analysis included ANOVA, correlation coefficients, and comparison between HTG and non-HTG groups. Significance was set at p < 0.05.
Results:
Among 155 infants analyzed, the overall HTG incidence was 28.4%. Incidence was significantly higher in lower gestational age (GA) infants (73.33% in ≤26 weeks vs 17.60% in >26 weeks) and very low BW infants (72.73% in < 750g vs 16.39% in ≥750g). Longitudinal analysis revealed that HTG infants had significantly higher initial triglyceride levels that decreased from week 1 to week 4 (249.14 to 145.33 mg/dL, overall ANOVA p=0.007; week 1 vs week 4 p=0.003), while non-HTG infants maintained stable levels throughout (127.97 to 131.04 mg/dL, p=0.541). HTG was significantly associated with lower GA (26.7 vs 28.7 weeks, p < 0.001), lower BW (794g vs 1029g, p < 0.001), and lower Apgar scores at both 1 minute (4.7 vs 5.9, p=0.002) and 5 minutes (7.2 vs 7.9, p=0.013). Correlation analyses revealed only weak associations between triglyceride levels and at-risk clinical variables, with BW showing the strongest negative correlation (r=-0.279). Maternal body mass index showed no significant difference between groups (p=0.218).
Conclusion:
This study demonstrates that preterm infants ≤26 weeks GA and < 750g BW are at highest risk for HTG development. The pattern of changing triglyceride levels and weak correlations with clinical risk factors suggest HTG is primarily related to infant maturity. These findings support the need for targeted monitoring strategies in high-risk infants, particularly during the first week of life. Future prospective studies are needed to establish optimal lipid administration protocols for these vulnerable infants and validate predictive risk factors for HTG development.
Affiliations
Advocate Children's Hospital, Advocate Lutheran General Hospital