Metabolic Bone Disease in the Preterm Infant: Current State and Future Directions

Overview

Journal World J Methodol

Publisher Baishideng Publishing Group

Specialty General Medicine

Date 2015 Sep 29

PMID 26413483

Citations 18

Authors

Moghis Ur Rehman

Hassib Narchi

Affiliations

Soon will be listed here.

Abstract

Neonatal osteopenia is an important area of interest for neonatologists due to continuing increased survival of preterm infants. It can occur in high-risk infants such as preterm infants, infants on long-term diuretics or corticosteroids, and those with neuromuscular disorders. Complications such as rickets, pathological fractures, impaired respiratory function and poor growth in childhood can develop and may be the first clinical evidence of the condition. It is important for neonatologists managing such high-risk patients to regularly monitor biochemical markers for evidence of abnormal bone turnover and inadequate mineral intake in order to detect the early phases of impaired bone mineralization. Dual-energy X-ray absorptiometry has become an increasingly used research tool for assessing bone mineral density in children and neonates, but more studies are still needed before it can be used as a useful clinical tool. Prevention and early detection of osteopenia are key to the successful management of this condition and oral phosphate supplements should be started as soon as is feasible.

Citing Articles

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References

Backstrom M, Kouri T, Kuusela A, Sievanen H, Koivisto A, Ikonen R . Bone isoenzyme of serum alkaline phosphatase and serum inorganic phosphate in metabolic bone disease of prematurity. Acta Paediatr. 2000; 89(7):867-73. View

Moyer-Mileur L, Brunstetter V, McNaught T, Gill G, Chan G . Daily physical activity program increases bone mineralization and growth in preterm very low birth weight infants. Pediatrics. 2000; 106(5):1088-92. DOI: 10.1542/peds.106.5.1088. View

Goulding A, Jones I, Taylor R, Williams S, Manning P . Bone mineral density and body composition in boys with distal forearm fractures: a dual-energy x-ray absorptiometry study. J Pediatr. 2001; 139(4):509-15. DOI: 10.1067/mpd.2001.116297. View

Zamora S, Belli D, Rizzoli R, Slosman D, Bonjour J . Lower femoral neck bone mineral density in prepubertal former preterm girls. Bone. 2001; 29(5):424-7. DOI: 10.1016/s8756-3282(01)00596-8. View

Nemet D, Dolfin T, Wolach B, Eliakim A . Quantitative ultrasound measurements of bone speed of sound in premature infants. Eur J Pediatr. 2002; 160(12):736-40. DOI: 10.1007/s004310100849. View

Faerk J, Peitersen B, Petersen S, Michaelsen K . Bone mineralisation in premature infants cannot be predicted from serum alkaline phosphatase or serum phosphate. Arch Dis Child Fetal Neonatal Ed. 2002; 87(2):F133-6. PMC: 1721456. DOI: 10.1136/fn.87.2.f133. View

Littner Y, Mandel D, Mimouni F, Dollberg S . Bone ultrasound velocity curves of newly born term and preterm infants. J Pediatr Endocrinol Metab. 2003; 16(1):43-7. DOI: 10.1515/jpem.2003.16.1.43. View

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(1):76-80. DOI: 10.1111/j.1651-2227.2003.tb00473.x. View

Hellstern G, Poschl J, Linderkamp O . Renal phosphate handling of premature infants of 23-25 weeks gestational age. Pediatr Nephrol. 2003; 18(8):756-8. DOI: 10.1007/s00467-003-1165-6. View

10.

Litmanovitz I, Dolfin T, Friedland O, Arnon S, Regev R, Shainkin-Kestenbaum R . Early physical activity intervention prevents decrease of bone strength in very low birth weight infants. Pediatrics. 2003; 112(1 Pt 1):15-9. DOI: 10.1542/peds.112.1.15. View

11.

Rubinacci A, Moro G, Boehm G, Terlizzi F, Moro G, Cadossi R . Quantitative ultrasound for the assessment of osteopenia in preterm infants. Eur J Endocrinol. 2003; 149(4):307-15. DOI: 10.1530/eje.0.1490307. View

12.

Litmanovitz I, Dolfin T, Regev R, Arnon S, Friedland O, Shainkin-Kestenbaum R . Bone turnover markers and bone strength during the first weeks of life in very low birth weight premature infants. J Perinat Med. 2004; 32(1):58-61. DOI: 10.1515/JPM.2004.010. View

13.

Aladangady N, Coen P, White M, Rae M, Beattie T . Urinary excretion of calcium and phosphate in preterm infants. Pediatr Nephrol. 2004; 19(11):1225-31. DOI: 10.1007/s00467-004-1574-1. View

14.

Pohlandt F, Mihatsch W . Reference values for urinary calcium and phosphorus to prevent osteopenia of prematurity. Pediatr Nephrol. 2004; 19(11):1192-3. DOI: 10.1007/s00467-004-1651-5. View

15.

Pittard 3rd W, Geddes K, Hulsey T, Hollis B . Osteocalcin, skeletal alkaline phosphatase, and bone mineral content in very low birth weight infants: a longitudinal assessment. Pediatr Res. 1992; 31(2):181-5. DOI: 10.1203/00006450-199202000-00019. View

16.

Eliakim A, Nemet D . Osteopenia of prematurity - the role of exercise in prevention and treatment. Pediatr Endocrinol Rev. 2005; 2(4):675-82. View

17.

Pelegano J, Rowe J, Carey D, LaBarre D, Edgren K, Lazar A . Effect of calcium/phosphorus ratio on mineral retention in parenterally fed premature infants. J Pediatr Gastroenterol Nutr. 1991; 12(3):351-5. DOI: 10.1097/00005176-199104000-00011. View

18.

Ashmeade T, Pereda L, Chen M, Carver J . Longitudinal measurements of bone status in preterm infants. J Pediatr Endocrinol Metab. 2007; 20(3):415-24. DOI: 10.1515/jpem.2007.20.3.415. View

19.

Chan G, Armstrong C, Moyer-Mileur L, Hoff C . Growth and bone mineralization in children born prematurely. J Perinatol. 2008; 28(9):619-23. DOI: 10.1038/jp.2008.59. View

20.

Wagner C, Greer F . Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008; 122(5):1142-52. DOI: 10.1542/peds.2008-1862. View