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Oral calcium supplementation in premature and asphyxiated meonates
Insights
Oral calcium supplements effectively prevent hypocalcemia in at-risk neonates. This intervention maintains higher serum calcium levels without negatively impacting key hormonal factors during early life.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Biochemistry
Background:
- Neonates, particularly premature and asphyxiated infants, are at high risk for hypocalcemia.
- Early life calcium intake is critical for neonatal homeostasis.
- Inadequate calcium from feedings can exacerbate hypocalcemia risk.
Purpose of the Study:
- To evaluate the biochemical and hormonal effects of oral calcium supplementation in high-risk neonates.
- To determine the efficacy of oral calcium in preventing hypocalcemia.
- To assess the impact on serum calcium, phosphate, magnesium, vitamin D, and parathyroid hormone levels.
Main Methods:
- Matched pairs study design comparing supplemented and control neonates.
- Oral calcium supplementation (75 mg/kg/24 hr) administered between 12 and 72 hours of age.
- Monitoring of serum calcium, phosphate, magnesium, 25-hydroxy-vitamin D3, and parathyroid hormone.
Main Results:
- Significantly higher serum calcium levels in supplemented infants during and after supplementation.
- No significant effect on serum phosphate, magnesium, 25-hydroxy-vitamin D3, or parathyroid hormone.
- Zero incidence of hypocalcemia in supplemented infants versus three in eight control infants after 12 hours of age.
Conclusions:
- Oral calcium supplementation is effective in preventing hypocalcemia in at-risk neonates.
- The intervention maintains higher serum calcium levels post-supplementation.
- It appears safe, with no adverse effects on critical calcium homeostasis factors.
Abstract:
Biochemical and hormonal effects of oral calcium supplementation in premature and asphyxiated neonates during the first few days of life are described. Eight pairs of infants were matched for gestational age and one-minute Apgar score. One member of each pair served as a control and the other was given supplemental oral calcium (75 mg/kg/24 hr) beginning at 12 and ending at 72 hours of age. The supplemental infants had significantly higher serum calcium values both during the time of supplementation and for 36 hours after supplementation was stopped. The oral calcium supplements had no significant effect on serum concentrations of phosphate, magnesium, 25-hydroxy-vitamin D3, or parathyroid hormone, The incidence of hypocalcemia after 12 hours of age was 0 in eight supplemented infants and three in eight control infants. In patients at risk for hypocalcemia, prospective use of oral calcium supplements during the period when there is inadequate calcium intake from feedings may prevent hypocalcemia, appears to be without deleterious effect on measurable chemical and hormonal factors important in calcium homeostasis, and results in maintenance of higher serum calcium levels after supplementation has been discontinued.