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Review
. 2014 Jul 4;1(3):85-91.
doi: 10.1016/j.jcte.2014.06.004. eCollection 2014 Sep.

Metabolic bone disease of prematurity

Stacy E Rustico  1   2 , Andrew C Calabria  1   2 , Samuel J Garber  3   2
Affiliations
Review

Metabolic bone disease of prematurity

Stacy E Rustico et al. J Clin Transl Endocrinol. .

Abstract

Metabolic bone disease (MBD) of prematurity remains a significant problem for preterm, chronically ill neonates. The definition and recommendations for screening and treatment of MBD vary in the literature. A recent American Academy of Pediatrics Consensus Statement may help close the gap in institutional variation, but evidence based practice guidelines remain obscure due to lack of normative data and clinical trials for preterm infants. This review highlights mineral homeostasis physiology, current recommendations in screening and monitoring, prevention and treatment strategies, and an added perspective of a bone health team serving a high volume referral neonatal intensive care center.

Keywords: ALP, Alkaline phosphatase; ELBW, Extremely low birth weight; MBD, Metabolic bone disease; Metabolic bone disease; Osteopenia; PTH, Parathyroid hormone; Prematurity; Rickets; TRP, Tubular reabsorption of phosphate; VLBW, Very low birth weight.

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Figures

Figure 1
Figure 1
Radiographs – A) Normal mineralization of the proximal humerus in a six month old former full term infant; growth plate formation is shown (arrow), B) Early demineralization in the humerus of a six month old former ELBW preterm infant with periosteal reaction (arrow), C) and D) Severe demineralization with features of rickets including cupping and fraying of metaphyses, healing fracture (arrow), and cortical thinning. Images are courtesy of Dr. Janet Reid, The Children's Hospital of Philadelphia.
Figure 2
Figure 2
Algorithm for screening and monitoring MBD.
See this image and copyright information in PMC

References

    1. Backstrom M.C., Kuusela A.L., Maki R. Metabolic bone disease of prematurity. Ann Med. Aug 1996;28(4):275–282. - PubMed
    1. Takada M., Shimada M., Hosono S., Tauchi M., Minato M., Takahashi S. Trace elements and mineral requirements for very low birth weight infants in rickets of prematurity. Early Hum Dev. Jun-Jul 1992;29(1–3):333–338. - PubMed
    1. Rigo J., Pieltain C., Salle B., Senterre J. Enteral calcium, phosphate and vitamin D requirements and bone mineralization in preterm infants. Acta Paediatr. Jul 2007;96(7):969–974. - PubMed
    1. Brooke O.G., Lucas A. Metabolic bone disease in preterm infants. Arch Dis Child. Jul 1985;60(7):682–685. - PMC - PubMed
    1. Vachharajani A.J., Mathur A.M., Rao R. Metabolic bone disease of prematurity. Neoreviews. 2009;10:e402–e411.

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