Status of osteopenia of prematurity in Sub-Himalayan region of India-a single centre experience

Background: Preterm infants are at significant risk to develop osteopenia of prematurity (OOP) due to inadequate supply of calcium and phosphorus. Although its exact prevalence is difficult to quantify because of the different methods used to screen infants 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. Objective of the study was to find out the status of OOP in Sub-Himalayan region of India. Methods: In this cross-sectional prospective study 101 preterm babies <32 weeks of gestation were evaluated. Biochemical parameters which included serum calcium (Ca), phosphate (P), alkaline phosphatase (ALP), and 25-OH vitamin D3 was done on day 1 of life, then weekly for 4 weeks and then at discharge. X-ray wrist was taken on day 1 of life. Results: At admission 78 (77.2%) neonates were osteopenic (60.4% with grade-1 and 16.8% grade-2). Calcium levels were not significantly low whereas serum phosphorus levels and vitamin D3 levels were significantly low. Serum ALP levels were found significantly high. Conclusions: Infants born prematurely have a predisposition to OOP. Serum calcium alone is not a good marker since its level is maintained at expense of loss of bone calcium. But serum phosphorus, ALP and vitamin D are better indicators of disease.