How common are radiologically apparent rib fractures in extremely low birth weight (ELBW) preterm born infants?

Smurthwaite, Denise; Wright, Neville; Russell, Shirley B.; Emmerson, A J B; Mughal, Zulf

doi:10.1016/j.bone.2007.04.093

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“…Fractures have been observed in about 30% of VLBW infants [ 22 , 23 ] in the eighties. In ELBW infants from that time, improved nutrition with enrichment with minerals have reduced the reported incidences of fractures at least down to 7–10% [ 24 , 25 ] and radiological BMDP down to 15% [ 26 ]. Even though the actual incidence of BMDP or fractures is unknown, ELBW infants are especially at risk [ 24 , 27 ].…”

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confidence: 99%

Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake

2021

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Background: With current Ca and P recommendations for enteral nutrition, preterm infants, especially VLBW, fail to achieve a bone mineral content (BMC) equivalent to term infants. During the first 3 years, most notably in light at term equivalent age (<−2 Z score) VLBW infants’ BMC does not catch up. In adults born preterm with VLBW or SGA, lower adult bone mass, lower peak bone mass, and higher frequency of osteopenia/osteoporosis have been found, implying an increased risk for future bone fractures. The aim of the present narrative review was to provide recommendation for enteral mineral intake for improving bone mineral accretion. Methods: Current preterm infant mineral recommendations together with fetal and preterm infant physiology of mineral accretion were reviewed to provide recommendations for improving bone mineral accretion. Results: Current Ca and P recommendations systematically underestimate the needs, especially for Ca. Conclusion: Higher enteral fortifier/formula mineral content or individual supplementation is required. Higher general mineral intake (especially Ca) will most likely improve bone mineralization in preterm infants and possibly the long-term bone health. However, the nephrocalcinosis risk may increase in infants with high Ca absorption. Therefore, individual additional enteral Ca and/or P supplementations are recommended to improve current fortifier/formula mineral intake.

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