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Bone mineral metabolism in the micropremie
J Rigo1, M De Curtis, C Pieltain
1Department of Pediatrics, University of Liège, CHR Citadelle, Belgium. J.Rigo@ulg.ac.be
Insights
Extremely low birth weight (ELBW) infants face risks of poor growth and bone issues. Optimized nutrition and monitoring are crucial for catch-up growth and long-term health in these vulnerable infants.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Pediatric Endocrinology
Background:
- Extremely low birth weight (ELBW) infants are susceptible to postnatal growth deficiency and osteopenia.
- Factors like nutrition, hormones, and medical treatments impact skeletal development in VLBW infants.
Purpose of the Study:
- To highlight the risks of growth deficiency and osteopenia in ELBW infants.
- To emphasize the importance of monitoring and nutritional support for preterm infants' skeletal growth and mineralization.
Main Methods:
- Utilizing dual-energy X-ray absorptiometry (DXA) to assess mineral status and body composition.
- Careful evaluation of weight gain and linear growth in the initial weeks and post-discharge.
- Conducting nutritional surveys to optimize feeding regimens.
Main Results:
- DXA is a key technique for evaluating mineral status and the impact of dietary changes in preterm infants.
- Close monitoring of growth parameters is essential during the neonatal period and after discharge.
- Extended nutritional support is necessary to promote catch-up growth and mineralization.
Conclusions:
- Optimizing nutritional supply and providing follow-up support are critical for ELBW infants' skeletal development.
- Further research is needed to define optimal feeding strategies and assess long-term outcomes on growth and bone health.
Abstract:
Environmental factors, nutritional supplies, hormonal status, diseases, and treatments appear to affect postnatal skeletal growth and mineralization in VLBW infants. Compared with their term counterparts, ELBW infants are at risk of postnatal growth deficiency and osteopenia at the time of hospital discharge. From recent data, DXA is becoming one of the reference techniques to evaluate mineral status, whole-body composition, and effects of dietary manipulations on weight gain composition and mineral accretion in preterm infants. Weight gain and length increases need to be evaluated carefully during the first weeks of life, in the intensive care unit and out of it, in the step down unit. Nutritional survey is required to improve the nutritional supply and to maximize linear growth. As the critical epoch of growth extends, during the first weeks or months after discharge, follow-up and nutritional support need to be provided during the first years to promote early catch-up growth and mineralization. Further studies need to determine precisely the most optimal feeding regimen during this period but also need to evaluate the long-term implications of such a policy on stature, peak bone mass, and general health at adulthood.