Screening of Serum Alkaline Phosphatase and Phosphate Helps Early Detection of Metabolic Bone Disease in Extremely Low Birth Weight Infants

Frontiers in Pediatrics

article

Hui Zhang¹  Qiong Jia¹  Meihua Piao¹  Yanmei Chang¹  Jinghui Zhang¹  Xiaomei Tong¹  Tongyan Han¹ 

[1] Department of Pediatrics, Peking University Third Hospital

关键词: metabolic bone disease;    alkaline phosphatase;    phosphate;    extremely low birth weight infants;    preterm infants;   

DOI  :  10.3389/fped.2021.642158

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Extremely low birth weight (ELBW, 500 IU/L, P ≥4.5 mg/dL), and severe (ALP >500 IU/L, P 4 weeks after birth) according to the time of onset. Results: A total of 142 ELBW infants were included, with a median gestational age of 28.1 (26.5–29.7) weeks and a median birth weight of 875 (818–950) g. Seventy-three cases of MBD were diagnosed, and the total prevalence was 51.4% (mild MBD, 10.6%; and severe MBD, 40.8%). Male sex, breastfeeding, and sepsis would increase the risk of severe MBD. Most MBD in ELBW infants occurred at 3–4 weeks after birth. Sixty-two percent (45/73) of infants were diagnosed as having early MBD, which are diagnosed earlier than late MBD [24 (21–26) vs. 39 (36–41), t = −7.161; P < 0.001]. Male sex [odds ratio (OR), 2.86; 95% confidence interval (CI), 1.07–7.64; P = 0.036], initial high ALP levels (OR, 1.02; 95% CI, 1.01–1.03; P < 0.001), and breastfeeding (OR, 5.97; 95% CI, 1.01–25.12; P = 0.049) are independent risk factors for the development of early MBD. Conclusion: The risk of MBD among ELBW infants is very high. Most cases occurred early and were severe. Male sex, initial high ALP levels, and breastfeeding are closely related to the increased risk of early MBD. Serial screening of serum ALP and P helps early detection of MBD; it is recommended to start biochemical screening for ELBW infants 2 weeks after birth and monitor their biochemical markers weekly.

【 授权许可】

CC BY