66 Fractures in a Neonatal and Intensive Care Unit: Frequency and Evolution Over Time.

Abstract

Objective: Aim of the study was to analyse fractures possible causes in premature or at term newborn babies, taking into account hematochemical, nutritional, clinical and instrumental parameters. Methods: A retrospective analysis involving 12.573 newborns (preterm and at term) identified 39 patients with fractures. The following parameters were analysed to assess their correlation to the development of fractures: central venous catheter (CVC) and/or umbilical venous catheter (UVC) placement, prematurity, steroid and diuretic medication, physiotherapy, biochemical parameters (calcemia, phosphatemia and serum alkaline phosphatase), diagnostic procedures (X-ray and ultrasound). Results: Our data suggest that a high birth weight did not represent a further risk factor for fractures. Comparison between time of fracture and gestational age (GA) has shown that fractures occurred later in babies with lower GA. In addition CVC or UVC placements, as well as steroid or diuretic medication, did not favour fractures. Bronchopulmonary dysplasia (BPD) or necrotizing enterocolitis (NEC) were not responsible for an increased fracture incidence. On the contrary a twofold fracture incidence was found in preterms babies undergoing physiotherapy in comparison to at term babies. Conclusions: Calcium metabolism and the interventional and diagnostic procedures we assessed did not correlate with increased onset of fractures; special preterm feeding formulas did not appear to reduce the risk of fractures over the time. Physiotherapy is the only factor determining an increased risk of fractures among those examined.