Prevention of postnatal bone demineralization in very low-birth-weight infants by individually monitored supplementation with calcium and phosphorus.

Abstract:

:Preterm infants are more prone to bone mineral deficiency the lower their birth weight. To achieve the intrauterine bone mineral accretion rate postnatally, 74 low-birth-weight infants (median birth weight, 980 g; range 430-1.580 g) were each supplemented enterally and/or parenterally with calcium and/or phosphorus in gradually increased amounts. The aim was to yield a simultaneous urinary excretion of Ca and inorganic phosphorus (Pi) at low concentrations (1-2 mmol/L) in spot urine specimens taken twice weekly. The hypothesis was that the intrauterine mineralization rate (4.5 mg cm-1/100 g weight gain) would be achieved postnatally in very low-birth-weight infants, if they were supplemented with enough Ca and/or Pi to effect at least a low (1-2 mmol/L) simultaneous urinary excretion of both ions, as compared with infants who do not excrete both ions and would accrete the bone minerals at a lower rate. The change in bone mineral content was measured by single photonabsorption densitometry and related to weight gain during periods of 2 to 6 wk. Infants who simultaneously excreted Ca (> 1.2 mmol/L) + Pi (> 0.4 mmol/L) in more than half of the urine samples retrospectively showed the highest bone mineral accretion, 5.1 mg cm-1/100 g weight gain, which was equivalent to the fetal mineralization rate (4.5). In this group the bone mineral status significantly contributed to the variance of the bone mineral accretion rate; severely demineralized infants showed a catch-up mineralization. A significantly lower rate (2.4) was observed in infants who excreted Ca+Pi in less than half of the urinary samples.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Pediatr Res

journal_title

Pediatric research

authors

Pohlandt F

doi

10.1203/00006450-199401000-00027

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

125-9

issue

1

eissn

0031-3998

issn

1530-0447

journal_volume

35

pub_type

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