Incidence of Metabolic Bone Disease in Preterms <32 Weeks Gestation in a Tertiary Care Center: A Prospective Observational Study

Abstract

Background

Metabolic bone disease (MBD) is an important cause of morbidity in preterms. Approximately 16%-40% of very low birth weight babies develop MBD. In low-income countries, its incidence may be higher.

Objective

To estimate the incidence of MBD in our population and to describe the clinical profile and the factors associated with it.

Methodology

Study design: A prospective observational study. Study participants: All preterm babies born <32 weeks and admitted in the neonatal intensive care unit of a tertiary care center with parental consent for the study.

Outcome

Incidence of MBD, clinical profile and factors associated with it.

Results

The incidence of MBD was found to be 40%. 88.8% cases of MBD were detected at 2 weeks of postnatal age but as gestational age decreased, there was a trend for late presentation. 22.38% of babies did not respond in the initial 2 weeks of treatment. ≤28 weekers required more time for resolution. Multivariable analysis of the risk factors identified on univariate analysis showed delayed attainment of full feeds and delayed starting of mineral supplementation (>14 days) as the independent risk factors. Alkaline phosphatase was elevated only in 2.9% of cases. All anthropometric parameters showed a significant decrease in the MBD group at 40 weeks.

Conclusion

The incidence of MBD in ≤32 weekers in this study is similar to other studies from developed countries. In the majority, it will get manifested from 2 weeks of age. Progression to full feeds and starting of mineral supplementation should be addressed well.