Osteopenia of prematurity: The cause and possible treatment

Steichen, Jean J.; Gratton, Tari L.; Tsang, Reginald C.

doi:10.1016/s0022-3476(80)80861-4

Cited by 194 publications

(92 citation statements)

References 20 publications

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“…All received, however, considerably less than the expected intrauterine accretion rates of approximately 150 mg Ca and 95 mg P per kg body weight per day (38). Furthermore, Steichen et al (34) found that a mineral supply similar to our regime was inadequate to prevent osteopenia in small premature infants. The high 1,25-(OH)2D concentrations beyond the perinatal period may therefore represent a normal compensatory effect to ensure maximum Ca and P absorption from a relatively mineral deficient diet (12,15).…”

Section: Resultsmentioning

confidence: 78%

Plasma Concentrations of Vitamin D Metabolites in Premature Infants

et al. 1984

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Section: Resultsmentioning

confidence: 78%

Plasma Concentrations of Vitamin D Metabolites in Premature Infants

et al. 1984

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“…13,14 During the neonatal period, preterm infants have bone mineralization problems such as osteopenia and rickets. [1][2][3] Evidence of poor bone mineralization, rickets and bone fractures has been reported in more than 30% of infants with birth weights less than 1000 g. 15,16 One of the major causes of bone problems is calcium and phosphorus deficiency in the postnatal period, either from an inability to tolerate adequate enteral feeding or from a deficient mineral intake when fed low calcium and phosphorus milk, such as human milk or standard term infant formula. Relatively, poor fat absorption during the neonatal period may also interfere with calcium and vitamin D absorption.…”

Section: Discussionmentioning

confidence: 99%

“…Causes of osteopenia of prematurity include calcium, phosphorus and vitamin D deficiency, liver and renal disorders, and medications such as steroids and diuretics. 1,2 Many of these preterm infants suffer poor growth and fractures. 3 However, the long-term consequences of osteopenia are important, as more preterm infants are surviving.…”

Section: Introductionmentioning

confidence: 99%

Growth and bone mineralization in children born prematurely

et al. 2008

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Objective: To study the growth and bone mineralization of children born prematurely.Study Design: A cohort of healthy children who were born prematurely with birth weight less than 1.5 kg were compared by weight and height to a national reference. Bone mineral status of preterm infants was compared with children who were born at term gestation. The average follow-up was 7 years. A sample of children who were born prematurely was recalled from an infant nutrition study. Children born at term gestation who had similar body weight for age were recruited from the community. Bone mineral evaluation was conducted in a group of 20 children born prematurely with birth weight less than 1.5 kg and in 15 children born at term gestation. Body weight for age was similar between the groups. All children were born of appropriate size for gestational age at birth. All children had their body weight and height measured. Comparisons for growth assessment status were made with the NHANES III database and published standards. Dietary intakes and food frequency were analyzed. The bone mineral status was measured at two sites, lumbar spine and distal third radius bone.Results: The average age was 7 years, with a range of 5 to 9 years. Compared with the reference population, children who were born prematurely on the average had lower weights, heights and body mass index. Preterm children had a lower lumbar bone mineral content than term children, 12.8 ± 3.0 and 14.7 ± 2.2 g cm À1 (P<0.05). The lumbar bone mineral density was lower in the preterm group than in the term group, 0.525±0.062 and 0.574±0.073 g cm À2 , respectively (P<0.04). Three of the preterm children had a history of fracture whereas none of the term children reported any fractures. Conclusion:Children who were born prematurely with birth weights less than 1.5 kg tend to be significantly smaller for age and have lower lumbar spinal bone mineral content and density compared with children born at term gestation.

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“…Although adequate for most nutrients, human milk (preterm or term) appears to contain insufficient amounts of calcium, phosphorus and possibly iron to meet the requirements of the low birth weight infant. Delayed bone mineralization (22,27,28) and rickets (20) have been documented in premature infants being fed breast milk or cow's milk formulas containing varying amounts of calcium and vitamin D. Although the etiology of defective bone mineralization may be complex and involve hormonal and/or substrate imbalance, most investigators feel that dietary substrate deficiency may be the single most important factor. Ziegler et al (30) and Shaw et al (27) have demonstrated that intrauterine accretion rates of calcium exceed 100 mg/kg/day, and of phosphorus 50 mg/kg/day, during the last 8 wk of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Differences in the Composition of Preterm and Term Human Milk during Early Lactation

et al. 1982

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SummaryThe composition of human milk from mothers delivering prematurely (PT) and at term (T) was studied over the first weeks of lactation. Complete 24 h milk expressions were obtained by electric pump at weekly or biweekly intervals through 44 wk conceptual age (120 samples from 20 PT mothers and 28 samples from 7 T mothers). PT milk was found to contain significantly higher concentrations than T milk of the following nutrients: total nitrogen, protein nitrogen, sodium, chloride, magnesium and iron. No differences were found between T and PT milk for nonprotein nitrogen, volume, solids, total calories, lactose, fat, fatty acids, potassium or calcium. The nutrients supplied to a 33 wk preterm infant fed 200 ml/kg/day of "average" PT milk were in excess of theoretic intrauterine requirements for all substrates except calcium and phosphorus. PT human milk is theoretically more suitable for the premature infant than either mature or term human milk, but may be deficient in specific nutrients for the very low birth weight baby. SpeculationThe compositional differences in preterm milk (increased protein and mineral content) are generally characteristic of colostrum. These changes may therefore reflect a prolonged colostral phase in premature mothers who are establishing lactation by artificial means during periods of emotional stress. Thus, the changes denoted for preterm milk may reflect the circumstances surrounding the onset of lactation rather than the nutritional requirements of the preterm infant.Controversy persists regarding the propriety of human milk for the feeding of preterm infants. Although insufficient data are available to determine exact nutritional requirements of the premature baby (16), Fomon et al. (10) have appropriately questioned the adequacy of mature breast milk in relation to estimated needs. While providing theoretically beneficial nonnutritional factors, mature human milk may be quantitatively deficient in protein, calcium, sodium and possibly other nutrients for the premature (10). Clinical studies of premature infants fed mature breast milk have yielded conflicting results (8,14,19,25), although the data generally indicate that mature human milk does not provide optimal nutritional support to the low birth weight infant.Recent investigations offer intriguing data which indicate that the composition of milk from mothers delivering prematurely differs from that of term mothers during the early weeks of lactation. Atkinson et al. (2) and Gross et al. (15) have confirmed a higher concentration of protein nitrogen in preterm milk, while Gross et al. also found an increased level of sodium in the premature mothers' milk. These findings suggest that preterm milk is theoretically more suitable for the premature infant than is mature milk. The present investigation was performed to assess, in a comprehensive fashion, the composition of milk from mothers delivering prematurely and at term over the same period of lactation. Further, the study was designed to control for many variables known to af...

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Osteopenia of prematurity: The cause and possible treatment

Cited by 194 publications

References 20 publications

Plasma Concentrations of Vitamin D Metabolites in Premature Infants

Plasma Concentrations of Vitamin D Metabolites in Premature Infants

Growth and bone mineralization in children born prematurely

Differences in the Composition of Preterm and Term Human Milk during Early Lactation

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