scholarly journals Preventive use of Calcitriol versus cholecalciferol on biochemical markers of Metabolic Bone Disease (MBD) in very low birth weight infants: a pilot randomized clinical trial

2021 ◽  
Author(s):  
Mohammad bagher Hosseini ◽  
Nafiseh Hosseini ◽  
Taher Entezari-Maleki ◽  
Zakieh Salimi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Biochemical Markers ◽  
Metabolic Bone Disease ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Hydroxyvitamin D ◽  
Metabolic Bone ◽  
25 Hydroxyvitamin D

About 55% of extremely-low-birth-weight (birth weight < 1000 g) and 23% of very-low-birth-weight infants (birth weight < 1500 g) suffer from metabolic bone disease (MBD). There are limited data on the use of calcitriol (1, 25-dihydroxycholecalciferol) to prevent or treat MBD in preterm infants. Therefore, this study aimed to compare the preventive effect of calcitriol and cholecalciferol on the biochemical markers of MBD in preterm infants. This study was a pilot randomized controlled trial conducted in the Alzahra teaching hospital of Tabriz University of Medical Sciences. we randomized 72 very-low-birth-weight infants in two groups of calcitriol 0.25 µg/day and cholecalciferol 400 IU/day. Biochemical markers, including serum 25-hydroxyvitamin D, Alkaline phosphatase (ALP), Phosphorus (P), calcium (Ca), Parathyroid hormone (PTH), and tubular reabsorption of phosphate (TRP) levels were checked at baseline, three, and five weeks after medication, consecutively. After three weeks of supplementation, infants in the cholecalciferol group had higher levels of serum 25-hydroxyvitamin D (P=0.001) and lower levels of urine phosphate (P=0.009); There were no significant differences in other biochemical markers. At the end of the fifth week, there was no significant difference between the two groups in terms of biochemical markers. Conclusion: The study indicated that the use of cholecalciferol caused a lower urinary loss of phosphate in very-low-birth-weight infants at a short time; however, these findings were not sustained during the study period.

Higher Incidence Rates of Hypothyroidism and Late TSH Rise in Preterm Very-Low-Birth-Weight Infants at a Tertiary Care Center

2018 ◽  
Vol 89 (4) ◽  
pp. 224-232 ◽  
Author(s):  
Hala Tfayli ◽  
Lama Charafeddine ◽  
Hani Tamim ◽  
Joanne Saade ◽  
Rose T. Daher ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Newborn Screening ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Care Center ◽  
Compliance Rate ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Low Birth Weight Infants

Background/Aims: Preterm newborns with a very low birth weight (VLBW) of < 1,500 g have an atypical form of hypothyroidism with a delayed rise in TSH, necessitating a second newborn screening specimen collection. The aims of this study were to survey the compliance with second newborn screening to detect delayed TSH rise in VLBW preterm infants at a tertiary care center, and to determine the rate of atypical hypothyroidism. Methods: Retrospective review of the records of 104 preterm VLBW infants. Late TSH rise was defined as an increase in TSH concentration after 14 days of age in the presence of a normal initial screen. Results: The compliance rate was 92% for the second screening. High rates of hypothyroidism (16.3%) and of late TSH rise (4.8%) were detected. Patients with hypothyroidism had a significantly lower birth weight (p = 0.01) and longer hospital stay (p = 0.004). Patients with late versus those with early TSH rise had a significantly lower mean birth weight (851 ± 302 vs. 1,191 ± 121 g, p = 0.004). Conclusion: The rates of early and late TSH rise in this VLBW population were higher than those in the literature and could be due to the use of povidone-iodine disinfectants. The yield of a second TSH screening in this study was high indicating the need for vigilance in screening VLBW preterm infants.

scholarly journals Comparison of prevalence and characteristics of fractures in term and preterm infants in the first 3 years of life

2020 ◽  
Author(s):  
Liting Tong ◽  
Sarita Pooranawattanakul ◽  
Jaya Sujatha Gopal-Kothandapani ◽  
Amaka C. Offiah
Keyword(s):  
Emergency Department ◽  
Birth Weight ◽  
Linear Regression ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Categorical Variables ◽  
Metabolic Bone ◽  
Significant Difference

Abstract Background Preterm infants may be more vulnerable to fractures due to various factors, including metabolic bone disease, but an increased risk of fractures up to the age of 2 is unproven. Objective To compare fracture patterns in premature and full-term children in the first 3 years of life. Materials and methods A retrospective study was conducted. We excluded any child who returned with the same injury, with known metabolic bone disease, with any disease or condition known to reduce bone density, who received any medication known to affect Vitamin D metabolism within 3 months of enrollment or who had fractures post-surgery/resuscitation. Variables such as the number of fractures sustained each year, age of presentation to the Emergency Department and mechanism of injury were compared between the preterm and term groups using statistical analysis (χ2 and Fisher exact test for categorical variables and Student’s t-test for continuous variables). Simple linear regression was performed on the total number of fractures sustained by age 3. Results Forty-four children with fractures were included. Of these, none were born extremely preterm, 24 (55%) were preterm, and 20 (45%) were born at term. Mean gestational ages of the preterm and term groups were 32 weeks 3 days and 39 weeks 6 days, respectively. There were no extremely low birth weight or very low birth weight children. There was no significant difference in the number of fractures sustained yearly, the age of presentation to the Emergency Department or the site of fracture between preterm and term groups. Linear regression showed that the total number of fractures sustained by age 3 years was unrelated to prematurity status, gender or birth weight category. Conclusion No significant difference in fracture number or pattern was identified.

scholarly journals Effect of targeted vs standard fortification of breast milk on growth and development of preterm infants (≤ 32 weeks): study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanna Seliga-Siwecka ◽  
Anna Chmielewska ◽  
Katarzyna Jasińska
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Low Birth Weight Infants ◽  
Randomized Controlled ◽  
Link Type

Abstract Background Human milk is recommended for all very low birth weight infants. Breastmilk is highly variable in nutrient content, failing to meet the nutritional demands of this group. Fortification of human milk is recommended to prevent extrauterine growth retardation and associated poor neurodevelopmental outcome. However, standard fortification with fixed dose multicomponent fortifier does not account for the variability in milk composition. Targeted fortification is a promising alternative and needs further investigation. Methods This randomized controlled trial will recruit preterm infants (≤ 32 weeks of gestation) within the first 7 days of life. After reaching 80 ml/kg/day of enteral feeding, patients will be randomized to receive standard fortification (HMF, Nutricia) or targeted fortification (modular components: Bebilon Bialka, Nutricia—protein; Polycal, Nutricia—carbohydrates; Calogen, Nutricia—lipids). The intervention will continue until 37 weeks of post-conception age or hospital discharge. Parents and outcome assessors will be blinded to the intervention. The primary outcome measure is velocity of weight, length, and head growth until 36 weeks post-conceptional age or discharge. Secondary outcomes include neurodevelopment at 12 months assessed with Bayley Scale of Development III, repeated at 36 months; body composition at discharge and at 4 months; and incidence of necrotizing enterocolitis, sepsis, retinopathy of prematurity, and bronchopulmonary dysplasia. Discussion Targeted fortification has previously been shown as doable in the neonatal intensive care unit context. If it shows to improve growth and neonatal outcome, choosing the targeted fortification as a first line nutritional approach in very low birth weight infants may become a recommendation. Trial registration ClinicalTrials.govNCT03775785, Registered on July 2019.

Developmental Outcome of Very Low Birth Weight Infants with Intraventricular Hemorrhage

1993 ◽  
Vol 77 (3) ◽  
pp. 894-894 ◽  
Author(s):  
Anna J. Whitehead
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Poor Prognosis ◽  
Very Low Birth Weight ◽  
Ventricular Dilatation ◽  
Developmental Outcome ◽  
Low Birth Weight Infants

Analyses of data from 20 infants confirmed that ventricular dilatation in VLBW preterm infants carries poor prognosis for development, but not IVH alone.

Sign in / Sign up

Export Citation Format

Share Document