Effect of Mineral Supplementation on Bone Density in Premature Neonates

Overview

The authors investigated the bone density and parameters of bone metabolism in 25 premature neonates witha birth weight lower than 1500 g. The objective of investigation and care is to prevent the development of bonechanges which are caused mainly by a reduced supply of phosphorus and to a lesser extent of calcium and vitaminD. Human milk contains significantly less phosphorus and calcium as compared with the foetoplacentar circulation.Therefore in premature deliveries the period when higher mineral supplies are provided is markedly reduced, thisperiod being essential for the proper development of the neonatal skeleton.The authors recorded serum values of calcium, phosphorus, parathormone, ALP, osteocalcin and procollagenI; in urine the output of Ca, P and crosslinks. Densitometric examination revealed in all premature neonates atthe age of the foreseen time of delivery osteopenia or osteoporosis. During a check-up examination made after a 3- 8-month interval after the first examination when supplementation with calcium, phosphorus and vitamin D wasmade an increase of the bone mineral to 193 % according to bone mineral density (BMD) was found and 200 -350 % according to the total mineral content expressed as bone mineral content (BMC).This observation and a decline of markers of bone resorption provides evidence of the importance of supple-mentation not only from the aspect of prevention of metabolic osteopathies, but also for optimal growth andachievement of the peak bone mass comparable with the healthy full-term population.

Key words:
primary osteoporosis prevention, preterm newborns, supplementation, bone mineral content,dualphoton densitometry, accuracy and precision