Clinical profile and predictors of biochemical markers of metabolic bone disease in very preterm neonates: An observational study

Metabolic bone disease (MBD) is a significant concern in very preterm neonates, with clinical signs often delayed compared to biochemical and radiological markers. MBD was defined as serum phosphate <1.81 μmol/L and alkaline phosphatase >600 IU/L or alkaline phosphatase >1000 IU/L. Key risk factors included lower gestational age, lower birth weight, prolonged total parenteral nutrition, delayed attainment of full enteral feeding (>7 days), cholestasis, bronchopulmonary dysplasia, and anaemia requiring transfusion. Logistic regression identified delayed attainment of full enteral feeding (>7 days) as a significant predictor for developing MBD.