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ISSN 0187-5337 (Print)
Instituto Nacional de Perinatología

2014, Number 4

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Perinatol Reprod Hum 2014; 28 (4)

Incidence of osteopenia in premature newborns of less than 34 weeks’ gestation in a neonatal intensive care unit

Carsi-Bocanegra EE, Frausto-Cárdenas OY, Aguilar-Quiñones GC

Language: Spanish
References: 17
Page: 193-197
PDF size: 321.25 Kb.


ABSTRACT

Introduction: Every year, there are over 13 million premature infants worldwide. Osteopenia of prematurity is a metabolic disease in which demineralization of bones is seen; it is progressive and variable in severity. It is found in 30% of preemies less than 1,500 g and increases up to 50% if born weighing less than 1,000 g. Material and methods: A longitudinal, descriptive, prospective and comparative research was done including preterm babies of less than 34 weeks’ gestation. A follow-up of serum calcium, phosphorus and alkaline phosphatase was carried out in days 7, 14, 21 and 28 of life. An ANOVA test was used for statistic analysis. Results: After 5 babies were discarded, 16 preterm newborns were studied, of which 11 were female and 5 male. General prevalence of osteopenia was 31.2% but it increased up to 75% in those children born weighing less than 1,000 g. Diminished phosphorus was observed as well as a tendency of the alkaline phosphatase to increase from day 14. Eighty per cent of the patients studied had respiratory distress syndrome and bronchopulmonary dysplasia as well. Discussion: The risk factors identified were late enteral stimuli, prolonged parenteral nutrition, no use of organic phosphate, low amounts of vitamin D administered and no preventive physical activity. We noticed there are paraclinical data that may identify babies at high risk for osteopenia.


REFERENCES

  1. Gómez M, Danglot-Banck C, Aceves-Gómez M. Clasificación de los niños recién nacidos. Rev Mex Pediatr. 2012; 79: 32-9.

  2. Tucker J, McGuire D. Epidemiology of preterm birth. BMJ. 2004; 329: 675-8.

  3. Molina-Font JA. Nutrition and fetal growth. Early Hum Develop. 1998; 53: s51-60.

  4. Molina JA, Bayés R, Narbona E. Raquitismo del prematuro. Pasado y presente. Arch Pediatr. 1989; 40: 353-82.

  5. Fraser DR. Physiology of vitamin D and calcium homeostasis. Nestlé Nutrition Workshops Series. 1991; 21: 23-34.

  6. Koo W, Tsang R. Calcium, magnesium, phosphorus, and vitamin D. In: Tsang R, Lucas A, Uauy R, Zlotkin S, editors. Nutritional needs of the preterm infant. Scientific basis and practical guidelines. Baltimor: Williams and Wilkins; 1993: p. 135-55.

  7. Kimberly G, Choherty J. Identificación del recién nacido de alto riesgo y valoración de la edad gestacional. Prematuridad, hipermadurez, peso elevado y bajo peso para su edad gestacional. En: Choherty J, Stark A, editores. Manual de cuidados neonatales. 4a. ed. Barcelona: Masson; 2005. pp. 50-66.

  8. Lothe A, Sinn J, Stone M. Metabolic bone disease of prematurity and secondary hiperparathyroidism. J Paediatr Child Health. 2011; 47: 550-3.

  9. Jiménez J. Osteopenia del prematuro. Arch Pediatr Urug. 2006; 77: 290-2.

  10. Catache M, Leone C. Role of plasma and urinary calcium and phosphorus measurements in early detection of phosphorus deficiency in very low birthweight infants. Acta Paediatr. 2003; 92: 76-80.

  11. Tinnion R, Embleton N. How to use alkaline phosphatase in neonatology. Arch Dis Child Educ Pract Ed. 2012; 97: 157-63.

  12. Monash Newborn Southern Health. Evidence-based practice guideline for the management of feeding in Monash Newborn. (November 13, 2008). [Consultado abril de 2013]. Disponible en: http://www.monashhealth.org/icms_docs/929_Feeding_guideline.pdf

  13. Fewtrell M. Does early nutrition program later bone health in preterm infants? Am J Clin Nutr. 2011; 94: 5S-35S.

  14. Edmond K, Bahl R. Optimal feeding of low-birth-weight infants. Technical review. World Health Organization (WHO). 2006 [Consultado en agosto de 2013] Disponible en: http://whqlibdoc.who.int/publications/2006/9789241595094_eng.pdf.

  15. Watts S, Mactier H, Grant J. Is additional oral phosphate supplementation for preterm infants necessary?: An assessment of clinical audit. Eur J Pediatr. 2013; 172: 1313-9.

  16. Khadilkar V, Khadilkar A, Joshi S. Bone disease in preterm. Indian J Pediatr. 2007; 74: 945-6.

  17. Moraes C, Silveira R, Ernani M, Santos L, Procianoy R. Physical therapy reduces bone resorption and increases bone formation in preterm infants. Amer J Perinatol. 2012; 29: 573-8.




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