Parathormone and perinatal calcium homeostasis

Area of Science:

• Neonatal endocrinology
• Pediatric mineral metabolism

Background:

• Parathyroid hormone (PTH) and calcium homeostasis are critical for neonatal adaptation.
• Understanding early life hormonal and mineral profiles is essential for identifying at-risk infants.

Purpose of the Study:

• To investigate the dynamic changes in plasma parathormone (PTH) and calcium concentrations during the first week of life in various newborn populations.
• To compare these profiles in term, preterm, infants of diabetic mothers (IDM), and asphyxiated infants.

Main Methods:

• Analysis of 309 plasma specimens from 190 newborns within the first 7 days of life.
• Measurement of plasma parathormone (PTH) and calcium levels.
• Stratification of infants by gestational age, maternal diabetes status, and presence of asphyxia or hypocalcemia.

Main Results:

• PTH was detectable in cord blood, even with high calcium. Term infants showed increased PTH from day 3. Preterm and IDM infants had delayed PTH increases until day 4.
• Hypocalcemia was frequent in IDM and asphyxiated infants. IDM infants displayed a unique, persistently depressed plasma calcium profile.
• Asphyxiated infants had low calcium despite significantly higher PTH levels compared to term infants.

Conclusions:

• Neonatal PTH and calcium dynamics differ significantly based on gestational age, maternal health, and birth complications.
• Early identification and monitoring of calcium and PTH are crucial for managing hypocalcemia in vulnerable newborns.
• This study highlights distinct endocrine and metabolic challenges faced by preterm infants, IDM, and those experiencing birth asphyxia.