Hypercalcaemia in extremely low birthweight infants

Area of Science:

• Neonatal Medicine
• Pediatric Endocrinology
• Nutritional Science

Background:

• Extremely low birthweight infants (<1000 g) are vulnerable to metabolic disturbances.
• Hypercalcemia with hypophosphatemia can occur in neonates, particularly those receiving intravenous nutrition.
• Rickets of prematurity is a common complication in preterm infants.

Purpose of the Study:

• To describe cases of hypercalcemia and hypophosphatemia in extremely low birthweight infants.
• To investigate the association between feeding practices and these metabolic derangements.
• To evaluate the efficacy of phosphate supplementation in treating these conditions.

Main Methods:

• Retrospective case series of 10 extremely low birthweight infants.
• Analysis of feeding regimens (expressed breast milk and intravenous nutrition).
• Monitoring of plasma calcium and phosphate levels before and after phosphate supplementation.

Main Results:

• All 10 infants presented with hypercalcemia and hypophosphatemia within the first two weeks of life.
• Infants were primarily fed expressed breast milk with concurrent intravenous nutrition.
• Phosphate supplementation successfully normalized plasma calcium concentrations.
• A high incidence of rickets of prematurity was observed in this cohort.

Conclusions:

• Hypercalcemia with hypophosphatemia is a significant risk in extremely low birthweight infants on expressed breast milk and IV nutrition.
• Phosphate supplementation is an effective treatment for this specific electrolyte imbalance.
• Rickets of prematurity remains a prevalent issue despite correction of acute metabolic disturbances.