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Bone mineral accretion rate and calcium intake in preterm infants
A Horsman1, S W Ryan, P J Congdon
1MRC Bone Mineralisation Group, Department of Medical Physics, Leeds.
Insights
Mineral supplementation in preterm infants significantly increased bone mineral accretion. However, this intervention does not fully resolve osteopenia of prematurity, highlighting the complexity of nutritional support for premature neonates.
Area of Science:
- Neonatal Nutrition
- Pediatric Bone Metabolism
- Prematurity Research
Background:
- Preterm infants are at high risk for osteopenia due to immature bone development and limited nutrient intake.
- Nutritional strategies are crucial for optimizing bone health in vulnerable preterm neonates.
Purpose of the Study:
- To evaluate the impact of calcium and phosphorus supplementation on bone mineral accretion in preterm infants.
- To assess the relationship between nutrient intake and growth parameters in preterm neonates.
Main Methods:
- A cohort of 36 preterm infants (25-32 weeks' gestation) were divided into three feeding groups: breast milk, standard formula, and supplemented formula (calcium and phosphorus).
- All infants received vitamin D supplementation.
- Bone mineral content, weight, and length were measured, and nutrient intakes were recorded.
Main Results:
- No significant differences in growth rate (weight and length) were observed between groups.
- Infants receiving mineral-supplemented formula (group S) showed a significantly higher rate of mineral accretion compared to the other groups.
- Mineral accretion rate (M) was positively correlated with calcium intake.
Conclusions:
- Supplementation of calcium and phosphorus in the feed of preterm infants enhances bone mineral accretion.
- While beneficial, mineral supplementation alone cannot completely prevent or cure osteopenia of prematurity.
- Optimizing nutrient intake is critical for bone health in preterm infants.
Abstract:
Thirty six preterm infants (20 boys) of 25 to 32 weeks' gestation were observed from birth to around 40 weeks' postconception. When oral feeding became possible, nine received mother's own breast milk (group B), 15 formula feed (group F), and 12 formula feed supplemented with calcium (5 ml 10% calcium gluconate/100 ml feed) and phosphorus (0.5 ml 17% potassium phosphate similarly) (group S). All received a daily supplement of 400 IU vitamin D. Intakes of calcium, phosphorus, vitamin D, energy, and fluid volume were recorded. When oral feeding started, and near 40 weeks' postconception, bone mineral content of the forearm was measured by photon absorptiometry; weight and crown-heel length were also measured. After logarithmic transformation of the measurements, there were no significant intergroup differences between the mean rate constants for weight or crown-heel length describing growth during the observation period. The mean rate constant for mineral accretion (M) was significantly higher in group S than in both the others. Pooling all data, M was significantly correlated with calcium intake but not with any other variable. Mineral supplementation of feed can reduce but not cure osteopenia of prematurity.