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Published on: October 28, 2014
Perinatal calcium metabolism: physiology and pathophysiology
Stephanie C Hsu1, Michael A Levine
1Department of Pediatrics, The John Hopkins University, Baltimore, MD 21287, USA.
Insights
Neonatal mineral homeostasis disturbances, including calcium issues, are common, especially in premature or ICU infants. Understanding neonatal calcium metabolism is key for diagnosing and managing these conditions.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Biochemistry
Background:
- Mineral homeostasis disturbances are frequent in neonates, particularly premature or ICU-admitted infants.
- These issues often stem from exaggerated physiological transitions from intrauterine to extrauterine life.
- Genetic defects, intrauterine pathologies, birth stress, or immaturity can also cause calcium imbalances.
Purpose of the Study:
- To provide an overview of calcium metabolism during the neonatal transition.
- To discuss common causes of neonatal hypocalcemia and hypercalcemia.
- To highlight the importance of specific knowledge for diagnosis and management.
Main Methods:
- Review of neonatal mineral metabolism and calcium physiology.
- Discussion of etiological factors for hypocalcemia and hypercalcemia.
- Emphasis on the unique biochemical and clinical features in newborns.
Main Results:
- Neonatal calcium disturbances are common and multifactorial.
- Causes range from physiological adaptation to genetic defects and pathological conditions.
- Specific knowledge of neonatal mineral metabolism is crucial.
Conclusions:
- Effective diagnosis and management of neonatal hypocalcemia and hypercalcemia rely on understanding perinatal mineral physiology.
- The chapter emphasizes the unique aspects of newborn mineral metabolism.
- Awareness of common causes aids in clinical decision-making for affected infants.
Abstract:
Disturbances in mineral homeostasis are common in the neonatal period, especially in premature infants and infants who are hospitalised in an intensive care unit. In many cases these disturbances are thought to be exaggerated responses to the normal physiological transition from the intrauterine environment to neonatal independence. By contrast, some disturbances in calcium homeostasis are the result of genetic defects, which in many instances can now be identified at the molecular level. In other cases hypocalcaemia or hypercalcaemia may result from pathological intrauterine conditions, birth trauma or stress, or fetal immaturity. Diagnosis and management of hypocalcaemia and hypercalcaemia in the neonate and infant requires specific knowledge of perinatal mineral physiology and the unique clinical and biochemical features of newborn mineral metabolism. In this chapter we will provide a brief overview of calcium metabolism with an emphasis on the neonatal transition, followed by discussion of the common causes of hypercalcaemia and hypocalcaemia.
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