Approach to Metabolic Bone Disease of Prematurity

Neonatal metabolic bone disease (MBD), osteopenia of prematurity (OOP), neonatal rickets or rickets of prematurity, are terms used to describe a reduction in bone mineral content (BMC) of the preterm infant. Although its exact prevalence is difficult to quantify because of the various methods used for screening of infants who are at risk and also because of the difficulty in the interpretation of these results, it has been steadily increasing with the survival of more immature neonates as a result of advances in neonatal care. Pathological conditions which impair placental macro and micronutrients transfer, such as preeclampsia, intrauterine growth restriction, and chorioamnionitis are associated with an increased risk of MBD in preterm infants. There are no specific diagnostic methods for MBD of prematurity. The clinical findings appear late and sometimes the diagnosis is not carried out. Indeed, it is necessary to screen the subjects who are at risk to develop MBD. The prevalence and also the severity of OOP can be reduced by early nutritional intervention. Maintaining a sufficient supply of Ca and P for the growth of VLBW infants’ skeleton is challenging because of their relatively high physiological requirements. Because of the crucial role of mechanical forces on the development of the skeleton, daily exercises such as gentle compression and movements of the limbs are recommended in infants at risk of OOP