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The effect of calcium and phosphorus supplementation on metabolic bone disorders in premature infants
Insights
Calcium and phosphorus supplements did not significantly impact osteopenia or growth in premature infants. Further research with longer durations and varied supplement doses is recommended for infant bone health.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Bone Metabolism
Background:
- Premature infants are at high risk for osteopenia, a condition characterized by reduced bone mass.
- Adequate calcium and phosphorus are crucial for bone development, especially in vulnerable preterm neonates.
- Understanding the impact of supplementation is vital for optimizing infant bone health outcomes.
Purpose of the Study:
- To investigate the effects of calcium and phosphorus supplementation on radiological and biochemical markers of osteopenia in premature infants.
- To assess the influence of these minerals on the growth parameters of preterm neonates.
- To provide evidence-based recommendations for the nutritional management of osteopenia in this population.
Main Methods:
- A randomized clinical trial involving 40 premature infants over six months.
- Infants received standard care with vitamin D, with one group receiving additional calcium and phosphorus supplements.
- Biochemical markers (serum calcium, phosphorus, alkaline phosphatase) and growth parameters were monitored bi-weekly; wrist X-rays assessed osteopenia at study end.
Main Results:
- No significant effect of calcium and phosphorus supplementation was observed on biochemical parameters or growth in the trial group.
- While weight, length, and head circumference increased significantly over time, this was not attributed to the intervention.
- Phosphorus and alkaline phosphatase levels decreased significantly during the follow-up period, independent of supplementation.
Conclusions:
- Calcium and phosphorus supplementation did not demonstrate a significant benefit in preventing osteopenia or improving growth in the studied premature infants.
- The findings suggest that current supplementation strategies may not be sufficient or that longer-term studies with adjusted dosages are needed.
- Further research is recommended to explore optimal mineral supplementation protocols for enhancing bone health in preterm neonates.
Objective:
To determine the impact of calcium and phosphorus on radiological and biochemical characteristics of osteopenia in premature infants.
Methods:
The randomised clinical trial study was conducted at Valie-e-Asr Hospital of Zanjan city, Iran, from December 2010 to June 2011. It involved monitoring 40 premature neonates over a period of six months. The babies, who were fed with breast milk and 400 units of vitamin D daily, were randomly divided into two equal groups. One group received supplement of calcium and phosphorus. Serum calcium, phosphorus and alkaline phosphatase levels as well as growth parameters (including weight, height, and head circumference) were measured every two weeks. At the end of the study, wrist X-ray was done for evaluation of osteopenia. Data was analysed using SPSS 16.
Results:
Radiological changes, characteristic of osteopenia, were found in 8 (40%) cases and 13 (65%) controls (p < 0.113). The mean of weight, length and head circumference increased significantly from second to sixth week during follow-up (p < 0.0001). Phosphorus and alkaline phosphatase activity decreased significantly from second to sixth week of follow-up (p < 0.02, p < 0.01 respectively). However, repeated measurement analyses did not show significant effect of intervention in biochemical and growth parameters in the trial group.
Conclusion:
The study didn't show significant effect of calcium and phosphorus on prevention of osteopenia and improvement of growth. Further studies of longer duration and with different doses of supplement are recommended.
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