Metabolic Bone Disease of Prematurity: Risk Factors and Associated Short-Term Outcomes
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Identificadores
URI: http://hdl.handle.net/20.500.11940/16163
PMID: 33321828
DOI: 10.3390/nu12123786
ISSN: 2072-6643
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Fecha de publicación
2020Título de revista
Nutrients
Tipo de contenido
Journal Article
DeCS
duración de estancia hospitalaria | cociente de probabilidades relativas | cribado neonatal | factores de riesgo | estudios prospectivos | estudios retrospectivos | peso al nacer | transfusión de eritrocitos | enfermedades óseas | modelos logísticos | nutrición parenteral | edad gestacional | fosfatasa alcalina | evaluación de riesgos | humanos | lactante | fosfatosMeSH
Risk Factors | Odds Ratio | Gestational Age | Length of Stay | Logistic Models | Parenteral Nutrition | Birth Weight | Neonatal Screening | Phosphates | Risk Assessment | Alkaline Phosphatase | Erythrocyte Transfusion | Bone Diseases | Prospective Studies | Retrospective Studies | InfantResumen
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; p = 0.045) and that birth weight (OR/100 g, 0.853; CI95%, 0.731-0.991; p = 0.039) and red blood cell transfusion (OR, 2.661; CI95%, 1.308-5.467; p = 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.
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