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ORIGINAL ARTICLE
Year : 2020  |  Volume : 18  |  Issue : 1  |  Page : 8-17

Some biochemical and radiological markers of bone mineral content in premature neonates


1 Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
2 Department of Rheumatology and Immunology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt

Correspondence Address:
Wafaa A.E Abd El-Hafeez Salem
Assiut 71631
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AZMJ.AZMJ_108_19

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Background and aim Inadequate supplementation of calcium and phosphorus in preterm infants significantly increases the risk of reduction of bone mineral content. As birth weight and/or gestational age increase, metabolic bone disease prevalence decreases and vice versa. This study aims to investigate and evaluate biochemical and radiological markers as early predictors of bone mineral content in preterm infants of up to 4 months of age. Patients and methods A case–control study included 20 preterm infants born less than 37 weeks of last menstrual period and 20 full term infants born greater than 37 weeks are involved as a full term group. Both groups are presented to the Neonatology Department, Al-Azhar University, Assuit, Egypt. Full history, full clinical examination, and investigations were done: complete blood count, serum alkaline phosphatase (ALP), serum total calcium (Ca), serum phosphorus (P), and wrist radiograph. Results According to investigations, there was no significant difference between preterm and full term infants in serum calcium and serum ALP at birth (P>0.05 for each), while there was significant difference between preterm and full term infants according to serum phosphorus, as the mean serum phosphorus in the preterm group (1.06±0.21) was lower than the mean serum phosphorus in the full term group (2.16±0.19) (P<0.05 for each) at birth. There was significant difference between investigation results in the preterm group at 2 months and at 4 months according to serum phosphorus, serum ALP, as these investigations increase after 4 months in the preterm group. There was no significant difference according to serum calcium at 2 months and 4 months (P>0.05). Also, cases with rickets increase after 4 months in the preterm group (P<0.05 for each). There was significant difference between the age of 2 and 4 months regarding bone changes in patients with rickets, as cases with widening, cupping, and fraying increases after 4 months in the preterm group (P<0.05). Conclusion Metabolic bone disease in preterm infants is affected by gestational age and birth weight. As birth weight and/or gestational age increase, metabolic bone disease prevalence decreases and vice versa. Assessment of serum ALP and serum phosphorus have helped to identify and expect preterm infants with high risk of metabolic bone disease.


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