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Updated: Jan 16, 2026

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Risk Factors for Early Neonatal Hypocalcemia in Preterm Neonates Born After 32 Weeks Gestation.

Jelena Sabljić1,2, Edita Runjić2,3, Klara Čogelja1,2

  • 1Department of Gynaecology and Obstetrics, Division of Neonatology, University Hospital of Split, 21 000 Split, Croatia.

Children (Basel, Switzerland)
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Summary

Fetal growth restriction (FGR) significantly reduces the risk of early neonatal hypocalcemia in preterm infants. However, cesarean delivery increases this risk, warranting closer monitoring for affected neonates.

Keywords:
acid–base balanceblood gas analysiscardiotocographycesarean sectionfetal growth restrictionhypocalcemianeonate

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Area of Science:

  • Neonatology
  • Perinatal Medicine
  • Pediatric Endocrinology

Background:

  • Early neonatal hypocalcemia is a prevalent metabolic disorder in premature infants.
  • Risk factors include perinatal asphyxia and fetal growth restriction (FGR).
  • Investigating FGR's impact and other risk factors on neonatal hypocalcemia is crucial.

Purpose of the Study:

  • To determine the incidence of early neonatal hypocalcemia in preterm neonates with and without FGR.
  • To explore maternal and neonatal risk factors, including cardiotocography, for early neonatal hypocalcemia.
  • To analyze the relationship between FGR, cesarean delivery, and neonatal hypocalcemia.

Main Methods:

  • Secondary analysis of a retrospective, single-center, case-control study.
  • Inclusion of 24 neonates with FGR and 124 controls (33-36 6/7 weeks gestational age).
  • Logistic regression analysis to identify risk factors for early neonatal hypocalcemia.

Main Results:

  • Neonates with FGR had significantly higher serum calcium levels (2.178 vs. 2.042 SD) and lower hypocalcemia incidence (4.35% vs. 42.75%) compared to controls.
  • FGR was associated with a 96.3% reduction in the probability of early neonatal hypocalcemia.
  • Cesarean delivery increased the odds of early neonatal hypocalcemia by 2.702 times.

Conclusions:

  • Fetal growth restriction (FGR) is linked to a decreased probability of early neonatal hypocalcemia.
  • Cesarean delivery is associated with an increased probability of early neonatal hypocalcemia.
  • Screening neonates delivered via cesarean section for hypocalcemia is recommended; cardiotocography and blood gas analysis are not predictive.