Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes
Despite the importance of early recognition of metabolic bone disease (MBD) of prematurity, there is still significant variability in screening practices across institutions. We conducted an observational study of infants born at ≤32 weeks of gestation with a birth weight of ≤1500 g (n = 218) to ide...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-12-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/12/12/3786 |
| _version_ | 1797545139056410624 |
|---|---|
| author | Alejandro Avila-Alvarez Adela Urisarri Jesús Fuentes-Carballal Natalia Mandiá Andrea Sucasas-Alonso María L. Couce |
| author_facet | Alejandro Avila-Alvarez Adela Urisarri Jesús Fuentes-Carballal Natalia Mandiá Andrea Sucasas-Alonso María L. Couce |
| author_sort | Alejandro Avila-Alvarez |
| collection | DOAJ |
| description | Despite the importance of early recognition of metabolic bone disease (MBD) of prematurity, there is still significant variability in screening practices across institutions. We conducted an observational study of infants born at ≤32 weeks of gestation with a birth weight of ≤1500 g (n = 218) to identify clinical factors associated with biochemical indicators of MBD. Bone mineral status was assessed by measuring alkaline phosphatase and phosphate levels between weeks 3 and 5 of life. Two comparisons were performed after classifying infants as either MBD (cases) or non-MBD (controls), and as either high or low risk for MBD, as determined based on the results of MBD screening. In total, 27 infants (12.3%) were classified as cases and 96 (44%) as high-risk. Compared with controls, MBD infants had a significantly lower gestational age and birth weight, and a longer duration of parenteral nutrition and hospital stay. Respiratory outcomes were significantly poorer in high- versus low-risk infants. Multivariate logistic regression showed that birth weight was the only independent risk factor for MBD (odds ratio [OR]/100 g, 0.811; confidence interval [CI95%], 0.656–0.992; <i>p</i> = 0.045) and that birth weight (OR/100 g, 0.853; CI95%, 0.731–0.991; <i>p</i> = 0.039) and red blood cell transfusion (OR, 2.661; CI95%, 1.308–5.467; <i>p</i> = 0.007) were independent risk factors for high risk of MBD. Our findings provide evidence of risk factors for MBD that could help clinicians to individualize perinatal management. The association of red blood cell transfusion with MBD is a novel finding that may be related to iron overload and that merits further study. |
| first_indexed | 2024-03-10T14:11:14Z |
| format | Article |
| id | doaj.art-e65e644c57534841a44c9d6bf4944f9c |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T14:11:14Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-e65e644c57534841a44c9d6bf4944f9c2023-11-21T00:10:44ZengMDPI AGNutrients2072-66432020-12-011212378610.3390/nu12123786Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term OutcomesAlejandro Avila-Alvarez0Adela Urisarri1Jesús Fuentes-Carballal2Natalia Mandiá3Andrea Sucasas-Alonso4María L. Couce5Neonatology Unit, Pediatrics Department, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruña, SpainFaculty of Medicine, Universidad de Santiago de Compostela, 15704 Santiago de Compostela, SpainNeonatology Unit, Pediatrics Department, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruña, SpainNeonatology Department, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, SpainNeonatology Unit, Pediatrics Department, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruña, SpainFaculty of Medicine, Universidad de Santiago de Compostela, 15704 Santiago de Compostela, SpainDespite the importance of early recognition of metabolic bone disease (MBD) of prematurity, there is still significant variability in screening practices across institutions. We conducted an observational study of infants born at ≤32 weeks of gestation with a birth weight of ≤1500 g (n = 218) to identify clinical factors associated with biochemical indicators of MBD. Bone mineral status was assessed by measuring alkaline phosphatase and phosphate levels between weeks 3 and 5 of life. Two comparisons were performed after classifying infants as either MBD (cases) or non-MBD (controls), and as either high or low risk for MBD, as determined based on the results of MBD screening. In total, 27 infants (12.3%) were classified as cases and 96 (44%) as high-risk. Compared with controls, MBD infants had a significantly lower gestational age and birth weight, and a longer duration of parenteral nutrition and hospital stay. Respiratory outcomes were significantly poorer in high- versus low-risk infants. Multivariate logistic regression showed that birth weight was the only independent risk factor for MBD (odds ratio [OR]/100 g, 0.811; confidence interval [CI95%], 0.656–0.992; <i>p</i> = 0.045) and that birth weight (OR/100 g, 0.853; CI95%, 0.731–0.991; <i>p</i> = 0.039) and red blood cell transfusion (OR, 2.661; CI95%, 1.308–5.467; <i>p</i> = 0.007) were independent risk factors for high risk of MBD. Our findings provide evidence of risk factors for MBD that could help clinicians to individualize perinatal management. The association of red blood cell transfusion with MBD is a novel finding that may be related to iron overload and that merits further study.https://www.mdpi.com/2072-6643/12/12/3786metabolic bone diseaseprematurityosteopeniaphosphatealkaline phosphatasered blood cell |
| spellingShingle | Alejandro Avila-Alvarez Adela Urisarri Jesús Fuentes-Carballal Natalia Mandiá Andrea Sucasas-Alonso María L. Couce Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes Nutrients metabolic bone disease prematurity osteopenia phosphate alkaline phosphatase red blood cell |
| title | Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes |
| title_full | Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes |
| title_fullStr | Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes |
| title_full_unstemmed | Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes |
| title_short | Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes |
| title_sort | metabolic bone disease of prematurity risk factors and associated short term outcomes |
| topic | metabolic bone disease prematurity osteopenia phosphate alkaline phosphatase red blood cell |
| url | https://www.mdpi.com/2072-6643/12/12/3786 |
| work_keys_str_mv | AT alejandroavilaalvarez metabolicbonediseaseofprematurityriskfactorsandassociatedshorttermoutcomes AT adelaurisarri metabolicbonediseaseofprematurityriskfactorsandassociatedshorttermoutcomes AT jesusfuentescarballal metabolicbonediseaseofprematurityriskfactorsandassociatedshorttermoutcomes AT nataliamandia metabolicbonediseaseofprematurityriskfactorsandassociatedshorttermoutcomes AT andreasucasasalonso metabolicbonediseaseofprematurityriskfactorsandassociatedshorttermoutcomes AT marialcouce metabolicbonediseaseofprematurityriskfactorsandassociatedshorttermoutcomes |