A.S.P.E.N. Clinical Guidelines

Nehra, Deepika; Carlson, Susan; Fallon, Erica M.; Kalish, Brian T.; Potemkin, Alexis K.; Gura, Kathleen M.; Simpser, Edwin; Compher, Charlene; Puder, Mark

doi:10.1177/0148607113487216

Cited by 60 publications

(33 citation statements)

References 65 publications

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“…The last 3 months of pregnancy are important because the fetus acquires 80% of calcium and phosphorus reserves between 25 and 40 weeks of gestation. [ 8 , 9 ] In this period, the mean deposition rates of calcium and phosphorus are 100 to 120 and 50 to 65 mg/kg/day, which provide the newborn with 20 and 10 g of calcium and phosphorus reserves. If preterm birth occurs in this period, the newborn will partially or completely miss the optimal stage of acquiring calcium and phosphorus reserves.…”

Section: Discussionmentioning

confidence: 99%

Risk factors analysis and prevention of metabolic bone disease of prematurity

et al. 2018

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The present study aims to analyze the risk factors for metabolic bone disease (MBD) of prematurity.A total of 238 preterm infants who were born at <34 weeks of gestation and were hospitalized for at least 6 weeks in the Department of Neonatology, Fujian Maternity and Children Hospital between January 1, 2011 and November 30, 2015 were enrolled in the study. Sixteen preterm infants diagnosed with MBD were selected as the case group, and 32 non-MBD preterm infants were matched 2:1 at admission into the study. The 2 groups were compared to examine the differences in maternal obstetric conditions, conditions during parturition, neonatal conditions, and neonatal diseases and treatments. The risk factors for MBD of prematurity were analyzed using t tests, χ2 tests, and a logistic regression model.The mean gestational age and birth weight of the case group were significantly lower (P < .05) than those of the control group. Compared with the control group, the case group had a significantly higher ratios of small-for-gestational-age infants, antenatal maternal corticosteroids use, sedative use, ventilator use, aminophylline use, diuretic use, liver function impairment, vitamin D (VitD) supplementation at more than 14 days of age, achievement of total enteral nutrition (TEN) beyond 28 days of age, and feeding intolerance.Logistic regression analysis showed that birth at <30 weeks of gestation, VitD supplementation at >14 days of age, and achievement of TEN beyond 28 days of age were independent risk factors for MBD (P < .05).Level of Evidence: IV

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Section: Discussionmentioning

confidence: 99%

Risk factors analysis and prevention of metabolic bone disease of prematurity

et al. 2018

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“…This is often an individualized approach based on clinical experience as there is limited research with which to guide providers. Enhanced formula continued until term benefits growth and bone health in otherwise well former preterm infants, but the data is insufficient for those with more comorbidities [34] . Transitional formula or breast milk fortification may be empirically provided until 40–52 weeks post-conceptional age [33] or up to 6 months if ongoing concerns for growth exist [35] .…”

Section: Post-dischargementioning

confidence: 99%

Metabolic bone disease of prematurity

Rustico

Calabria

Garber

2014

Journal of Clinical & Translational Endocrinology

134

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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.

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“… 93 The prevalence of atopy, allergic rhinitis, and asthma at age 31 y was higher in people who, as infants, had been supplemented regularly with approximately 2000 IU of vitamin D per day—a dose significantly higher than that usually recommended for infants. 94 Those associations (other than for asthma) remained significant after adjustment for potential confounders, but data for serum 25(OH)D concentrations were unavailable. Another study, reported an almost twofold increase in susceptibility to asthma and food hypersensitivity after supplementation with vitamin D (400 IU/d) and vitamin A (1000 IU) for the first year of life.…”

Section: Resultsmentioning

confidence: 99%

Do studies reporting ‘U’-shaped serum 25-hydroxyvitamin D–health outcome relationships reflect adverse effects?

Grant

Karras

Bischoff‐Ferrari

et al. 2016

Dermato-Endocrinology

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Several reports describe U-shaped 25-hydroxyvitamin D [25(OH)D] concentration–health outcomes, including musculo-skeletal disorders such as falls and fractures, several cancers, cardiovascular disease (CVD), cognitive function, all-cause mortality rates, birth outcomes, allergic reactions, frailty, and some other disorders. This paper reviews reports of U-shaped outcome associations with vitamin D status for evidence of underlying pathophysiological processes, or of confounding, finding that some U-shaped associations appear to be biologically meaningful, but that many could well reflect confounding by factors such as lifestyle, or hypovitaminosis D-related disease onset being masked by self-supplementation that was begun too late to correct developing health problems but before baseline vitamin D status assessment. However, the various U-shaped associations for allergic reactions may be due to vitamin D modulation of the phenotype of the immune response, shifting the Th1-Th2 balance toward Th2 formation. For prostate cancer, there seems to be little effect of 25(OH)D concentration on incidence; however, there is an inverse correlation between 25(OH)D concentration and mortality rates. Future observational studies, and randomized controlled trial data analyses, should include adjustment for data collected on prior long-term vitamin D supplementation and solar UVB exposure, as well as other potential confounders.

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A.S.P.E.N. Clinical Guidelines

Cited by 60 publications

References 65 publications

Risk factors analysis and prevention of metabolic bone disease of prematurity

Risk factors analysis and prevention of metabolic bone disease of prematurity

Metabolic bone disease of prematurity

Do studies reporting ‘U’-shaped serum 25-hydroxyvitamin D–health outcome relationships reflect adverse effects?

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