title: Highest Plasma Phenylalanine Levels in (Very) Premature Infants on Intravenous Feeding; A Need for Concern.
abstract: OBJECTIVE
  To analyse the association in newborns between blood levels of phenylalanine and feeding method and gestational age.
  
  
  METHODS
  This observational, cross-sectional study included a sample of 11,829 infants between 2008 and 2013 in a Spanish region. Data were recorded on phenylalanine values, feeding method [breast, formula, mixed (breast plus formula), or partial or fully intravenous feeding], gestational age in weeks (<32, 32-37, ≥37), gender and days since birth at the moment of blood collection. Outcomes were [phenylalanine] and [phenylalanine] ≥95th percentile. Associations were analysed using multivariate models [linear (means difference) and logistic regression (adjusted odds ratios)].
  
  
  RESULTS
  Higher phenylalanine values were associated with lower gestational age (p<0.001) and with intravenous feeding (p<0.001).
  
  
  CONCLUSIONS
  The degree of prematurity and intravenous feeding influenced the plasma concentration of phenylalanine in the newborn. Caution should be taken in [phenylalanine] for newborns with intravenous feeding, monitoring them carefully. Very preterm infants given the recommended amount of amino acids should also be strictly monitored. These findings should be taken into consideration and call for adapting the amounts to the needs of the infant.
authors.affiliation: Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University, San Juan de Alicante, Spain.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Cortés-Castell
authors.affiliation: Clinical Analysis Department, Alicante General University Hospital, Alicante, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Sánchez-González
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palazón-Bru
authors.affiliation: Department of Surgery, Paediatrics, Obstetrics and Gynaecology, University of Murcia, Murcia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bosch-Giménez
authors.affiliation: Clinical Analysis Department, Alicante General University Hospital, Alicante, Spain.
authors.forename: Herminia
authors.initials: H
authors.lastname: Manero-Soler
authors.affiliation: Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University, San Juan de Alicante, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Juste-Ruiz
authors.affiliation: Department of Nursing, University of Alicante, San Vicente del Raspeig, Spain.
authors.forename: María Mercedes
authors.initials: MM
authors.lastname: Rizo-Baeza
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain.
authors.forename: Vicente Francisco
authors.initials: VF
authors.lastname: Gil-Guillén
mesh_terms: D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D041943:Infant Formula / Q000008:administration & dosage; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D015999:Multivariate Analysis; D010288:Parenteral Nutrition; D010649:Phenylalanine / Q000097:blood*; D013030:Spain
chemical_list: D010649:Phenylalanine