Extended Data Fig. 1: Flowchart diagram of the dataset generation process.

The data were aggregated from the EHRs at Stanford Health Care. The linkage of the two datasets allowed for a combination of nutritional data, phenotypic traits, and long-term outcome data, among others. All EHR data were mapped to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) version 5.3.1, which included patient observations, procedures, medications, and conditions. Gestational age at delivery and birth weight were extracted from clinical notes in the newborns’ EHRs using regular expressions. For each newborn, their entire medical history available in the EHR corresponding to their days on TPN was extracted, including all conditions, observations, medications, and procedures, while excluding TPN medication records to avoid potential data leakage. Conditions, observations, medications, and procedures were organized by patient, date, and time of entry into the EHR system. Conditions that affect multiple organ systems were excluded. Initially, the Stanford cohort included 6,991 neonatal/pediatric patients in neonatal/pediatric intensive care units with 113,773 TPN orders recorded between January 2011 and January 2022. Of these, 5,913 patients were retained as they received their first TPN within the first 2 years of delivery, resulting in 79,790 TPN orders. EHR data were represented in a binary format for each condition, drug, procedure, and observation. The patients with congenital heart diseases were dropped for the TPN2.0 outcome comparison analysis. In addition, an independent external validation cohort was obtained from EHRs from the UCSF Hospital and Clinics and the Benioff Children’s Hospital. The UCSF EHR database contains demographics, specific lab measurements, and TPN data. This included all 3,417 patients who received their first TPN within the first 24 months of birth between October 2012 and January 2024 in the UCSF EHR Database, totaling 63,273 TPN orders.