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Summary
Preterm infants often experience hypocalcemia and rickets due to calcium-phosphate deficiency. Supplementing with phosphate alongside vitamin D is crucial for preventing these conditions in vulnerable newborns.
Area of Science:
- Neonatal physiology
- Pediatric nutrition
- Mineral metabolism
Context:
- Preterm infants have unique calcium-phosphate metabolism challenges.
- Gestational age significantly impacts fetal calcium accumulation.
- Postnatal hypocalcemia is more prevalent in preterm infants.
Purpose:
- To review the physiological and clinical aspects of calcium-phosphate metabolism in preterm infants.
- To highlight the prevalence and indicators of hypocalcemia and rickets in this population.
- To discuss optimal supplementation strategies.
Summary:
- Calcium accumulation is highest in late gestation, making preterm infants susceptible to hypocalcemia.
- Low serum phosphate levels, despite vitamin D supplementation, are common and linked to rickets.
- Increased alkaline phosphatase activity serves as an early indicator of rickets.
Impact:
- Emphasizes the inadequacy of vitamin D supplementation alone for preterm infants.
- Recommends combined vitamin D and phosphate supplementation for preventing rickets.
- Informs clinical practice regarding nutritional support for preterm neonates.