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Plasma alkaline phosphatase activity in the preterm neonate
Acta Paediatrica Scandinavica
|July 1, 1981
Summary
Preterm infants often show elevated alkaline phosphatase, indicating bone activity, even without rickets. This bone enzyme increase may reflect normal development during the third trimester and early newborn period.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Biochemistry
Background:
- Rickets is a significant concern in preterm infants.
- Vitamin D deficiency is a common cause of rickets.
- Monitoring bone metabolism in preterm infants is crucial.
Purpose of the Study:
- To investigate plasma alkaline phosphatase (ALP) activity in preterm infants.
- To determine the origin and significance of elevated ALP in this population.
- To differentiate physiological bone activity from pathological rickets.
Main Methods:
- Clinical and radiological diagnosis of rickets.
- Serial biochemical monitoring of preterm infants.
- Measurement of plasma alkaline phosphatase activity.
- Determination of ALP origin (bony).
Main Results:
- One preterm infant diagnosed with rickets despite vitamin D therapy died.
- Four control preterm infants showed a transient increase in plasma ALP, peaking around term-equivalent age.
- Elevated ALP was of bony origin in all infants studied.
- Radiological rickets confirmed in only one of the four control infants.
Conclusions:
- Markedly elevated plasma ALP is common in preterm infants.
- This elevation may represent physiological osteoblastic activity and bone mineralization.
- It reflects normal bone development during the third trimester and early neonatal period.