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Metabolic bone disease: a continued challenge in extremely low birth weight infants

Sreekanth Viswanathan1, Wasim Khasawneh2, Kera McNelis3

  • 1Division of Neonatology, Department of Pediatrics, Rainbow Babies & Children's Hospital, University Hospitals, Cleveland, OH, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|August 22, 2013
PubMed

Insights

Metabolic bone disease (MBD) affects nearly one-third of extremely low birth weight (ELBW) infants, often linked to lower nutrient intake and increased medical interventions. This condition is associated with higher mortality and longer hospital stays in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Pediatric Endocrinology
  • Nutritional Science

Background:

  • Metabolic bone disease (MBD) is a significant complication in premature infants, particularly those with extremely low birth weight (ELBW).
  • Research on MBD in ELBW infants is limited despite their high risk.
  • Understanding MBD incidence and risk factors in ELBW infants is crucial for improving outcomes.

Purpose of the Study:

  • To determine the incidence of MBD in extremely low birth weight (ELBW) infants.
  • To identify risk factors associated with MBD development in this population.
  • To describe the clinical characteristics and outcomes of ELBW infants with MBD.

Main Methods:

  • Retrospective analysis of ELBW infants admitted between 2005 and 2010, surviving over 8 weeks.
  • MBD diagnosis based on radiographic evidence of osteopenia or rickets.
  • Comparison of clinical characteristics, nutrient intake, and outcomes between infants with and without MBD.

Main Results:

  • The incidence of radiological MBD was 30.9% (71/230) in ELBW infants.
  • Infants with MBD were smaller, more premature, and had higher rates of mechanical ventilation, chronic lung disease, and prolonged parenteral nutrition.
  • Lower intake of calcium, phosphorus, vitamin D, protein, and calories was observed in MBD cases, associated with increased mortality and hospital stay.

Conclusions:

  • MBD remains a prevalent issue in ELBW infants, even with advancements in neonatal nutrition.
  • Factors such as prematurity, low birth weight, and specific medical interventions are linked to MBD.
  • Optimizing chronic lung disease management and early nutritional strategies is essential for reducing MBD in ELBW infants.
Abstract

Keywords:
enteral nutritionextremely low birth weight infantslife cyclemetabolic bone diseaseneonatesosteopeniaparenteral nutrition

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