Radiological rickets in extremely low birthweight infants.

Area of Science:

• Neonatal Medicine
• Pediatric Radiology
• Nutritional Pediatrics

Background:

• Extremely low birthweight (ELBW) infants (<1000 g) are at high risk for nutritional deficiencies.
• Rickets, a condition affecting bone mineralization, is a known complication in premature neonates.
• Early identification of rickets is crucial for timely intervention and preventing long-term skeletal morbidity.

Purpose of the Study:

• To prospectively determine the incidence of radiological rickets in infants with birthweight less than 1000 g.
• To assess the correlation between serum alkaline phosphatase levels and radiological findings of rickets.
• To evaluate the prevalence of osteopenia and spontaneous fractures in this high-risk neonatal population.

Main Methods:

• Prospective study involving wrist X-rays in 48 infants surviving >28 days with birthweight <1000 g.
• Radiological assessment for signs of osteopenia and classical rickets.
• Measurement of peak serum alkaline phosphatase levels.

Main Results:

• 54% of infants exhibited classical radiological changes of rickets.
• 21% showed osteopenia, while 25% had normal X-rays.
• 17% of the total cohort experienced spontaneous fractures; peak serum alkaline phosphatase showed poor correlation with radiological findings.

Conclusions:

• Radiological rickets is highly prevalent in extremely low birthweight infants.
• Standard biochemical markers like serum alkaline phosphatase may not accurately reflect the severity of bone disease in this population.
• Further research into optimal screening and management strategies for rickets in ELBW infants is warranted.