What question did this study set out to answer?

This review aims to summarize the risk factors, timing, and complications associated with hypercalcemia in newborns with subcutaneous fat necrosis.

April 24, 2026

Hypercalcemia in neonatal subcutaneous fat necrosis: A systematic review of risk factors, timing, and complications

Key Points

This review aims to summarize the risk factors, timing, and complications associated with hypercalcemia in newborns with subcutaneous fat necrosis.
Conducted a systematic search of literature in multiple databases for studies from 2015 to 2025.
Included case reports, case series, and observational studies reporting on SCFN and calcium data.
Data synthesized narratively to highlight risk factors, timing of onset, and complications.
Identified maternal risk factors including gestational diabetes mellitus and hypertension.
Noted that SCFN lesions typically appear within 3 weeks, with hypercalcemia developing within 8 weeks.
Found nephrocalcinosis to be the most common complication associated with hypercalcemia.

Abstract

Background Subcutaneous fat necrosis (SCFN) of the newborn is a rare panniculitis. It is characterized by erythematous, indurated nodules or plaques involving the back, buttocks, or extremities. Although the lesions usually resolve spontaneously, SCFN can be complicated by hypercalcemia. This complication may lead to significant morbidity and mortality. This review summarizes the risk factors, timing, and complications of hypercalcemia in SCFN. Method This review followed the PRISMA 2020 statement (Registration ID: CRD420251145895). A systematic search was conducted in PubMed, Scopus, ScienceDirect, EBSCO, and ProQuest for studies published between 2015 and 2025. Case reports, case series, observational studies, and reviews reporting SCFN with calcium data were included. Data on risk factors, timing of onset, and complications were synthesized narratively. Results Thirty-one studies were included. The most common reported maternal risk factors were gestational diabetes mellitus (GDM) (7/30) and hypertension or preeclampsia (5/30). Perinatal hypoxia, especially asphyxia (30/35), was the predominant neonatal factor. SCFN lesions typically appeared within the first 3 weeks of life (wks of life), while hypercalcemia developed within 8 wks of life. Nephrocalcinosis (NC) was the most common complication (18/28). Conclusion SCFN is a systemic condition with a substantial risk of delayed or persistent hypercalcemia. This review highlights the delayed onset of hypercalcemia, which may occur weeks after skin lesion development. These findings emphasize the need for extended monitoring, including serial calcium assessment and renal imaging, to prevent overlooked complications and improve neonatal outcomes.

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