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Catch it before it breaks!: managing metabolic bone disease of prematurity
Journal article

Catch it before it breaks!: managing metabolic bone disease of prematurity

Folasade Kehinde, Andreea Marinescu and Renee Turchi
Current opinion in pediatrics, v 33(6), pp 676-683
01 Dec 2021
PMID: 34734916

Abstract

Adult Bone Diseases, Metabolic - diagnosis Bone Diseases, Metabolic - therapy Humans Infant Infant, Newborn Infant, Premature Infant, Premature, Diseases Infant, Very Low Birth Weight Intensive Care Units, Neonatal Young Adult
Metabolic bone disease of prematurity, commonly referred to as osteopenia of prematurity, remains prevalent in the neonatal intensive care unit (NICU) despite recent medical advances. It is estimated that up to 60% of extreme low birth weight and 20% of very low-birth-weight infants have metabolic bone disease of prematurity. Often silent, it typically presents with poor growth, increased ventilator dependency and fractures. Clinical sequalae, such as short stature can extend into young adulthood. There is no universal consensus by neonatal intensive care unit clinicians on the screening, diagnosis, or treatment for metabolic bone disease of prematurity. The disease is often diagnosed late by radiographs or incidentally in this highly fragile population. Suggest screening using DEXA (dual-energy X-ray absorptiometry) scans or ultrasound, in combination with serum markers like alkaline phosphatase, phosphorous levels, parathyroid hormone, and tubular reabsorption of phosphate, might identify at-risk babies earlier. The use of protocol-based screenings may aid in early diagnosis. We present a review of the risk factors, recent screening methods, diagnosis and management of this prevalent, clinically relevant diagnosis, as well as propose a protocol for the early screening and management of this silent disease.

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Pediatrics
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