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Risk factors of bone mineral metabolic disorders
1Neonatology Unit, Hospital Infantil Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Insights
Neonatal bone metabolic disorders arise from imbalances in bone remodeling factors. This review details risks like prematurity, genetic issues, and nutritional deficits, impacting infant bone health.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Bone Biology
Background:
- Bone remodeling is a dynamic process influenced by mechanical, nutritional, hormonal, and molecular factors.
- Bone health in newborns relies on maintaining a balance among these diverse stimuli.
- Metabolic bone disease of prematurity is a common neonatal pathology due to insufficient mineral accretion during late gestation.
Purpose of the Study:
- To review and identify the multifaceted risk factors contributing to the development of bone metabolic disorders in neonates.
- To consolidate current knowledge on primary and secondary osteoporosis in term and preterm infants.
- To highlight the interplay of various intrinsic and extrinsic factors affecting neonatal bone health.
Main Methods:
- Comprehensive literature review of studies on neonatal bone metabolism and pathology.
- Analysis of factors including genetic, nutritional, hormonal, mechanical, and chronic disease influences.
- Synthesis of information regarding risk factors for osteopenia and osteoporosis in neonates.
Main Results:
- Identified prematurity as a key factor due to reduced mineral accretion.
- Detailed intrinsic bone tissue defects (primary osteoporosis) of genetic or idiopathic origin.
- Cataloged secondary osteoporosis risk factors: maternal/gestational issues, nutritional deficiencies (calcium, phosphorus, vitamin D), endocrine disorders, medications, mechanical influences, and chronic illnesses.
Conclusions:
- Neonatal bone metabolic disorders result from a complex interplay of genetic predispositions and environmental factors.
- Prematurity, nutritional deficits, and underlying chronic conditions significantly elevate the risk of osteopenia and osteoporosis in newborns.
- Understanding these diverse risk factors is crucial for timely diagnosis and effective management of bone health in neonates.
Abstract:
Bone remodeling is a complex process which integrates different stimuli factors such as mechanical, nutritional and hormonal factors as well as cytokines and growth factors. Bone health depends on an adequate balance between all these factors. The typical bone pathology of the newborn is the metabolic bone disease of prematurity, favored by a lack of mineral accretion in the third trimester of gestation. The intrinsic defects of the bone tissue (primary osteoporosis) are usually of genetic or idiopathic origin and can affect both the term and the preterm newborn. Other risk factors for osteopenia (secondary osteoporosis) include maternal or gestational factors, nutritional deficits (calcium, phosphorus, vitamin D), endocrinological alterations, use of certain medications antagonistic to bone metabolism, mechanical factors and chronic diseases (renal or hepatic insufficiency, intestinal malabsorption, collagen or metabolic diseases). This review examines the risk factors of developing bone metabolic disorders in neonates.
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