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Plasma ionized calcium, phosphate and magnesium in preterm and small for gestational age infants
N Nelson1, O Finnström, L Larsson
1Department of Paediatrics, University Hospital, Linköping, Sweden.
Insights
Preterm infants show lower ionized calcium levels, which correlate with gestational and postnatal age. Sickest infants had the lowest calcium, while magnesium levels were similar across groups.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Biochemistry
Background:
- Neonatal electrolyte balance is crucial for infant health.
- Preterm and small for gestational age infants may have altered mineral metabolism.
- Understanding these changes is vital for clinical management.
Purpose of the Study:
- To compare blood ionized calcium, phosphate, and magnesium levels in preterm and small for gestational age infants versus full-term newborns.
- To investigate the correlation of these minerals with gestational age, postnatal age, and infant health status.
Main Methods:
- Blood samples were collected on days 1, 3, and 5 from preterm infants (appropriate for gestational age and small for gestational age) and full-term newborns.
- Concentrations of ionized calcium, phosphate, and magnesium were measured.
- Statistical analysis was performed to compare groups and identify correlations.
Main Results:
- Preterm infants exhibited lower mean ionized calcium levels compared to full-term infants.
- Ionized calcium levels positively correlated with gestational and postnatal age; lowest levels were observed in the sickest infants.
- Small for gestational age infants had lower phosphate values, correlating with growth retardation severity on day 1.
- Magnesium concentrations increased over time and did not significantly differ between groups; no correlation with calcium or phosphate was found.
Conclusions:
- Ionized calcium levels are significantly affected by prematurity and postnatal development in neonates.
- Phosphate levels are influenced by intrauterine growth retardation in small for gestational age infants.
- Magnesium homeostasis appears largely preserved in these neonatal populations, independent of calcium and phosphate levels.
Abstract:
Blood concentrations of ionized calcium, phosphate and magnesium were determined on days 1, 3 and 5 in 32 preterm infants, appropriate for gestational age, and 25 small for gestational age infants. The results were compared with those of a reference group of 31 fullterm newborns. Preterm infants had lower mean ionized calcium levels than the reference population. Ionized calcium levels were positively correlated with gestational age and postnatal age. The sickest infants had the lowest calcium levels. Intrauterine growth retardation did not seem to influence the calcium levels. Small for gestational age infants had lower phosphate values than the reference group and the values correlated with the degree of growth retardation the first day. Magnesium concentrations increased with time and did not differ significantly between the study groups and the reference group. Magnesium values did not correlate with calcium or phosphate values.