Osteopenia of Prematurity: Does Physical Activity Improve Bone Mineralization in Preterm Infants?

Stalnaker, Kelsey A; Poskey, Gail

doi:10.1891/0730-0832.35.2.95

Cited by 25 publications

(18 citation statements)

References 27 publications

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“…Additional potential adverse outcomes of furosemide use in premature infants include metabolic bone disease (osteopenia) of prematurity and electrolyte abnormalities related to urinary loss of sodium, chloride, and calcium [ 53 – 55 ]. As with other adverse outcomes, the etiology of metabolic bone disease in premature infants likely has many causes, and infants with severe illness often have multiple risk factors such as insufficient phosphorus intake, vitamin D deficiency, prolonged immobilization, mechanical ventilation, and exposure to steroids and antibiotics [ 56 – 58 ]. However, there is a lack of consensus on the definition of metabolic bone disease of prematurity, with some definitions relying on serum mineral levels and others based on radiographical findings [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Association between furosemide in premature infants and sensorineural hearing loss and nephrocalcinosis: a systematic review

Jackson

Taylor

Selewski

et al. 2018

matern health, neonatol and perinatol

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Furosemide is a potent loop diuretic commonly and variably used by neonatologists to improve oxygenation and lung compliance in premature infants. There are several safety concerns with use of furosemide in premature infants, specifically the risk of sensorineural hearing loss (SNHL), and nephrocalcinosis/nephrolithiasis (NC/NL). We conducted a systematic review of all trials and observational studies examining the association between these outcomes with exposure to furosemide in premature infants.We searched MEDLINE, EMBASE, CINAHL, and clinicaltrials.gov. We included studies reporting either SNHL or NC/NL in premature infants (< 37 weeks completed gestational age) who received at least one dose of enteral or intravenous furosemide. Thirty-two studies met full inclusion criteria for the review, including 12 studies examining SNHL and 20 studies examining NC/NL. Only one randomized controlled trial was identified in this review. We found no evidence that furosemide exposure increases the risk of SNHL or NC/NL in premature infants, with varying quality of studies and found the strength of evidence for both outcomes to be low. The most common limitation in these studies was the lack of control for confounding factors.The evidence for the risk of SNHL and NC/NL in premature infants exposed to furosemide is low. Further randomized controlled trials of furosemide in premature infants are urgently needed to adequately assess the risk of SNHL and NC/NL, provide evidence for improved FDA labeling, and promote safer prescribing practices.Electronic supplementary materialThe online version of this article (10.1186/s40748-018-0092-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Association between furosemide in premature infants and sensorineural hearing loss and nephrocalcinosis: a systematic review

Jackson

Taylor

Selewski

et al. 2018

matern health, neonatol and perinatol

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“…However, for osteopenia in children, there was no universal consensus of the definition based on BMD Z ‐score. A specific diagnosis referring to metabolic bone disease in the preterm infant is osteopenia of prematurity, which is not based on BMD Z ‐score . One radiological study defined BMD Z ‐scores < −2 and between −1 and −2 as severe and mild osteopenia, respectively, while a recent St. Jude cohort regarding BMD in childhood ALL defined BMD Z ‐scores < −1.5 as low BMD .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of denosumab therapy for low bone mineral density in childhood cancer survivors: A report of preliminary experience

Huang

Liu

Hou

et al. 2019

Pediatric Blood & Cancer

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Background:In childhood cancer survivors, low bone mineral density (BMD) is a bone-related consequence. Efficacy of denosumab, an effective therapy for adult patients with osteoporosis, remains unclear in children. This study aimed to investigate denosumab therapy efficacy for low BMD in childhood cancer survivors. , we monitored lumbar BMD of children with cancer using dual-energy X-ray absorptiometry after completing chemotherapy with a 6month interval. For patients with low BMD, defined as height-adjusted Z-scores of BMD < −1.5 in this study, calcium carbonate and vitamin D supplements were initially administered. When low BMD continued for at least 6 months, denosumab therapy was introduced. Calcium and vitamin D supplementation were continued in patients on denosumab. We investigated BMD change and adverse effects during denosumab therapy. Results:During the study period, 20 patients received denosumab treatment. Mean heightadjusted Z-score of BMD before denosumab treatment was −2.68 but increased to −2, −1.96, and −1.33 at 0.5, 1, and 1.5 years after denosumab treatment, respectively (P = .012). In addition, hypocalcemia occurred in 40% (8/20) of patients; three patients had hypocalcemic symptoms with numbness in all four limbs. All hypocalcemic patients, except one patient who died due to relapsed leukemia, recovered well after continuous calcium supplementation. Conclusions:Denosumab is an effective treatment for low BMD in childhood cancer survivors.However, the complication of hypocalcemia might develop posttreatment. K E Y W O R D Sbone mineral density, cancer, children, denosumab, osteoporosis

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“…Das estratégias disponíveis na abordagem da DMO, as intervenções nutricionais e a estimulação física destacam-se como os pilares do controlo da doença e devem integrar a rotina de cuidados aos RN. 20 A monitorização laboratorial e as atitudes de intervenção devem ser mantidas mesmo após a alta, na doença instalada, ou enquanto se mantiverem os fatores de risco. A avaliação das manifestações clínicas tardias deve ser atentamente acompanhada nas consultas de Neonatologia, pelo impacto negativo na saúde destes doentes.…”

Section: Conclusãounclassified

Doença Metabólica Óssea da Prematuridade em Recém-Nascidos de Muito Baixo Peso: Estudo Observacional Retrospetivo

et al. 2019

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Introduction: Metabolic bone disease of prematurity consists in a decrease of bone matrix mineral content, in comparison with the level expected for gestational age. Screening of this condition is based on serum alkaline phosphatase and phosphate levels. The aim of this study is to evaluate the prevalence of metabolic bone disease of prematurity, to assess the aspects associated with a higher risk of this disease and to describe the growth of newborns with birth weight below 1500 g and metabolic bone disease of prematurity.Material and Methods: Observational, retrospective, multicenter and descriptive study in three neonatal intensive care units in Portugal, from May 1st 2016 to April 30th 2017. A convenience sample of very low birthweight newborns was obtained. Demographic, clinical, and laboratory variables were described in newborns with and without metabolic bone disease of prematurity.Results: A total of 53 newborns were included in this study: 30 males, 16 with gestational age ≤ 28 weeks. Five cases of metabolic bone disease of prematurity were diagnosed. In this group, the majority of patients was male and presented a lower gestational age and birth weight, in comparison with the group without metabolic bone disease of prematurity. The average duration of parenteral nutrition was higher in newborns with metabolic bone disease of prematurity and the calcium/phosphate ratio was lower than the recommended values. Growth was similar in both groups. No patient with metabolic bone disease of prematurity underwent physical rehabilitation.Discussion: The prevalence of metabolic bone disease of prematurity was 9.43%, which is lower than what is described in the literature. However, only 50% of newborns completed the screening according to the recommendations. The main risk factors identified concur with the literature.Conclusion: Metabolic bone disease of prematurity is a frequent but underdiagnosed comorbidity in very low birthweight newborns. It is essential to screen newborns at risk for this condition, using biochemical markers, as well as structure nutritional interventions and physical stimulation in order to avoid short and long-term consequences of this disease.

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Osteopenia of Prematurity: Does Physical Activity Improve Bone Mineralization in Preterm Infants?

Cited by 25 publications

References 27 publications

Association between furosemide in premature infants and sensorineural hearing loss and nephrocalcinosis: a systematic review

Association between furosemide in premature infants and sensorineural hearing loss and nephrocalcinosis: a systematic review

Efficacy and safety of denosumab therapy for low bone mineral density in childhood cancer survivors: A report of preliminary experience

Doença Metabólica Óssea da Prematuridade em Recém-Nascidos de Muito Baixo Peso: Estudo Observacional Retrospetivo

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