Fractures Associated with Metabolic Bone Disease in Extremely Preterm and Extremely Low Birth Weight Infants Before and After a Bone Health Program
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View abstract on PubMed
Summary
This summary is machine-generated.A structured Bone Health Program (BHP) significantly reduced fractures in extremely preterm infants. This program improved bone health outcomes and shortened hospital stays for infants who experienced fractures.
Area Of Science
- Neonatal care
- Pediatric bone health
- Metabolic bone disease research
Background
- Metabolic bone disease (MBD) in premature infants leads to fractures.
- Limited evidence exists on reducing fractures with structured Bone Health Programs (BHPs).
Purpose Of The Study
- To evaluate if a structured BHP reduces fracture incidence in extremely preterm and ELBW infants.
- To assess the impact of a BHP on biochemical and clinical outcomes.
Main Methods
- Retrospective cohort study of NICU admissions (2014-2024) for infants <28 weeks GA or <1000g birth weight.
- Compared pre-program era with a standardized BHP including biochemical surveillance, screening radiographs, optimized mineral targets, and pharmacist review.
- Analyzed fracture incidence, clinical course, and biochemical markers.
Main Results
- Fracture incidence decreased from 9.5% to 1.64% (RR 0.17, p<0.001), with NNT ≈ 13.
- Infants who fractured had shorter hospital stays (104 vs 172 days) post-program.
- Lower peak alkaline phosphatase and parathyroid hormone levels were observed post-program.
Conclusions
- A structured BHP significantly reduced fracture incidence and improved biochemical profiles in preterm infants.
- Program components like scheduled imaging and optimized nutrition are key.
- Further multicenter studies are needed to confirm generalizability.
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