Aetiological factors in rickets of prematurity.

Abstract

SUMMARY Six very preterm (<32 weeks' gestation) infants who developed late-onset respiratory distress were each matched for sex and gestation with 2 control preterm infants. Radiologically and biochemically the diagnosis of rickets and rachitic respiratory distress seemed clear and the pattern conformed with other reports of the syndrome. The control infants were of similar gestational ages but there was a significantly higher incidence of pre-eclampsia in the pregnancies of index cases. Also significant was a prolonged illness of several weeks' duration in the index cases; this illness was either heart failure due to patent ductus arteriosus or prolonged ventilation in the early weeks of life for apnoeic attacks. Awareness of these 2 aetiological factors shows the necessity of monitoring such infants for evidence of rickets. The use of water-soluble antirachitic prophylaxis such as 1 oc-hydroxyvitamin D or I,25-dihydroxy-vitamin D is sometimes indicated.

Plasma Concentrations of Vitamin D Metabolites in Premature Infants

“…Several factors are probably of pathogenetic importance (5,7,10,25,30), and deficient functions in all aspects of vitamin D metabolism have been implicated, such as: intestinal absorption (21, 31, 37), hepatic 25-hydroxylation (19,21,31), renal 1-hydroxylation (2 1, 3 l), and intestinal responsiveness to 1,25- Table 1. Daily intakes of vitamin D, Ca, and P when oral (0H)zD (8).…”

Elevated preeclampsia rates during winter with reduced sunlight dependent vitamin D production

“…Because early-life vitamin D deficiency has been associated with adverse health outcomes in offspring [34], neonates of preeclamptic mothers may be an easily identified group that needs a targeted intervention to improve vitamin D status from birth. Zeghoud et al, in stated that maternal vitamin D status correlates strongly with that of the newborn [35] and in a study on rickets of prematurity, preeclampsia was identified as a major risk factor [36].…”

Untitled

“…Hier waren typische klinische und radiologische Symptome die Rippenfrakturen Betroff ener, welche erstmals in den späten 70er-Jahren zum Teil mit anderen Begleiterkrankungen beschrieben wurden [ 5 ] . Danach kamen zahlreiche, systematische Studien in den 80er-Jahren zur Publikation, die einen Zusammenhang zwischen inadäquater Kalzium-und Phosphatzufuhr und der Entwicklung einer Frühgebore-nenosteopenie mit hochgradiger Frakturneigung belegten [ 2 ] . Fälschlicherweise wurden diese Frakturen in einem Teil der Fälle einem Fehlverhalten des ärztlichen, des Pfl ege-bzw.…”