Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity

Abdallah, Enas A.A.; Said, Reem N.; Mosallam, Dalia; Moawad, Eman Mohamed Ibraheim; Kamal, Naglaa M.; Fathallah, Mohammed G.E-D.

doi:10.1097/md.0000000000004837

Cited by 47 publications

(47 citation statements)

References 35 publications

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“…Serum ALP is a marker for the bone turnover. OP is characterized by low serum phosphate and elevated ALP levels . Serum ALP levels were significantly lower in post–nutrition‐nurse period, indicating better bone metabolism.…”

Section: Discussionmentioning

confidence: 99%

Employing a Nutrition Nurse in Neonatal Intensive Care Unit Improved Nutrition and Growth Outcomes in Preterm Neonates

et al. 2018

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Background: Nutrition nurses are clinical nurse specialists with knowledge and experience in nutrition support. We aimed to investigate the nutrition and growth outcomes after employment of a nutrition nurse in our level III neonatal intensive care unit (NICU). Methods: A retrospective cohort study including preterm neonates < 34 weeks and < 2000 g were conducted. Nutrition and growth outcomes of infants in pre-nutrition-nurse and post-nutrition-nurse periods were compared. Primary outcome was presence of postnatal growth retardation (PGR) at term-equivalent age (body weight < 10 percentile at 40 weeks postmenstrual age). Results: Infants in pre-nutrition-nurse (n = 38) and post-nutrition-nurse (n = 40) periods were similar with regard to gestational age, birth weight, gender, and perinatal characteristics. The initiation of parenteral nutrition after admission to NICU (30.8 ± 24.1 vs 6.7 ± 7.6 hours, P < 0,001) and attainment of full enteral feedings (27.3 ±18.1 vs 18.7 ± 11.3 days, P = 0.034) were earlier in post-nutrition-nurse period. First feeds were more commonly started with breast milk (29% vs 75%, P < 0.001); breastfeeding was more common at discharge (79% vs 95%, P = 0.045) and longer in duration (6.1 ± 7.3 vs 8.4 ± 6.3 months, P = 0.008) in postnutrition-nurse period. Primary outcome PGR at term-equivalent age was lower in post-nutrition-nurse period (57.9% vs 27.5%, P = 0.007). Conclusion: Employing a nutrition nurse improved quality of nutrition support, increased breastfeeding, and decreased PGR in preterm neonates. Further prospective evaluation of outcomes in the presence of a nutrition nurse is needed to generalize these findings to other NICUs. (Nutr Clin Pract. 2019;34:616-622)

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Section: Discussionmentioning

confidence: 99%

Employing a Nutrition Nurse in Neonatal Intensive Care Unit Improved Nutrition and Growth Outcomes in Preterm Neonates

et al. 2018

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“…O diagnóstico de DMO foi estabelecido com base nos marcadores bioquímicos com maior sensibilidade e especificidade na literatura: FA > 900 UI/L e P < 5,5 mg/dL [< 1,8 mmol/L], ou FA > 600 UI/L com tendência crescente e hipofosfatemia < 5,5 mg/dL persistente em avaliações seriadas. 3,12,13 Para a avaliação do crescimento estaturo-ponderal dos RN avaliaram-se os dados antropométricos (peso e comprimento) ao longo dos 12 meses em que o estudo decorreu. O cálculo do z-score foi realizado com base na idade corrigida (curvas de crescimento de Fenton até as 50 semanas de idade pós-menstrual e curvas de crescimento da Organização Mundial de Saúde a partir desta idade).…”

Section: Methodsunclassified

“…3,12,13 Assim, os valores FA > 900 UI/L associados a hipofosfatemia < 5,5 mg/dL [< 1,8 mmol/L] ou FA > 600 UI/L com tendência crescente e hipofosfatemia persistente < 5,5 mg/dL nas avaliações seriadas sugerem, de forma precoce, DMO. 12,13 O valor do Ca sérico é geralmente mantido dentro de valores normais, por ação da PTH, e neste sentido não constitui um marcador precoce de doença. 3 Os marcadores imagiológicos da doença apresentam alterações tardias e não estão indicados por rotina.…”

Section: Introductionunclassified

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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“…Diagnosis of ROP and staging were categorized according to international classification for ROP or need for intervention (laser, Avastin therapy, or surgery) [ 38 ]. Babies with alkaline phosphatase levels greater than 500 IU/L were diagnosed as MBD as per our unit policy [ 39 ]…”

Section: Methodsmentioning

confidence: 99%

Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance

et al. 2018

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There are concerns around safety and tolerance of powder human milk fortifiers to optimize nutrition in preterm infants. The purpose of this study was to evaluate the tolerance and safety of a concentrated preterm formula (CPF) as a liquid human milk fortifier (HMF) for premature infants at increased risk of feeding intolerance. We prospectively enrolled preterm infants over an 18-month period, for whom a clinical decision had been made to add CPF to human milk due to concerns regarding tolerance of powder HMF. Data on feed tolerance, anthropometry, and serum biochemistry values were recorded. Serious adverse events, such as mortality, necrotizing enterocolitis (NEC), and sepsis, were monitored. A total of 29 babies received CPF fortified milk during the study period. The most common indication for starting CPF was previous intolerance to powder HMF. Feeding intolerance was noted in 4 infants on CPF. The growth velocity of infants was satisfactory (15.9 g/kg/day) after addition of CPF to feeds. The use of CPF as a fortifier in preterm babies considered at increased risk for feed intolerance seems well tolerated and facilitates adequate growth. Under close nutrition monitoring, this provides an additional option for human milk fortification in this challenging subgroup of preterm babies, especially in settings with limited human milk fortifier options.

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Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity

Cited by 47 publications

References 35 publications

Employing a Nutrition Nurse in Neonatal Intensive Care Unit Improved Nutrition and Growth Outcomes in Preterm Neonates

Employing a Nutrition Nurse in Neonatal Intensive Care Unit Improved Nutrition and Growth Outcomes in Preterm Neonates

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

Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed Intolerance

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