607 Risk Factors for Intraventricular Hemorrhage in Less than 32 Weeks Gestation Preterm Infants - Prospective Study

Abstract

Abstracts association was found between CLD and apnea of prematurity, neonatal sepsis, nosocomial infection and ROP even after excluding deaths and outborn infants. Conclusions Low GA, BW, the severity of RDS but also the presence of perinatal infection were the main risk factors identified in preterm infants with CLD.

Risk Factors and Clinical Characteristics of Metabolic Bone Disease of Prematurity

“…Respiratory failure and difficulty weaning from the ventilator can also be seen in newborns with MPDP. 6 7 8 In the present study, durations of invasive and total mechanical ventilation were significantly higher compared with the control group. Sedation and analgesia applied during invasive mechanical ventilation create a risk for MBDP by leading to immobilization.…”

“…The diagnosis of MBDP is based on the determination of risk factors, biochemical changes, and radiographic abnormalities, since the clinical signs appear only in advanced forms of the disease. 7 It is therefore crucial to identify the risk factors that cause MBDP.…”

“…Although the use of diuretics such as loop diuretic has been cited as a risk factor for MBDP in many reports, it did not emerge as a risk factor in the present study. 2 3 4 5 6 7 8 This may be related to the use of thiazide group diuretics and increased absorption of Ca in some neonates. Systemic corticosteroids are sometimes used in infants with BPD or brain edema.…”

“…They can also affect bone metabolisms by reducing osteoblast activity, increasing osteoclast activity, lowering intestinal absorption of Ca and PO 4 , and increasing Ca renal excretion. 6 7…”

“…1 Preterm neonates, particularly with gestational ages ≤28 weeks and birth weight <1,500 g, with diuretic (e.g., furosemide) or long-term corticosteroid use due to severe chronic lung disease or other diseases, on long-term parenteral nutrition (>4 weeks), with histories of necrotizing enterocolitis (NEC), delayed establishment of full enteral feeding, and failure to tolerate formulae or human milk fortifiers are at high risk for development of MBDP. 2 3 4 5 6 7 8 This multifactorial disorder is characterized by inadequate postnatal bone mineralization, and clinical signs of diseases often occur within 5 to 11 weeks of life. 6 MBDP can cause respiratory failure, difficulty weaning from the ventilator, fractures, diastasis of cranial sutures, large anterior fontanel, frontal bossing, craniotabes, and deformities of the skull such as dolichocephaly, indentation of the ribs at diaphragm insertion, hypotonia, and postnatal growth failure.…”