Critical analysis of pathophysiological, diagnostic and therapeutic aspects of metabolic bone disease in very low birth weight infants

Abstract

OBJECTIVE: To perform a systematic review on the pathophysiology, diagnosis and approach of metabolic bone disease in very low birth weight infants. SOURCES: Literature review of articles published in Medline within the last twenty years. SUMMARY OF THE FINDINGS: The higher survival of very low birth weight infants was concurrent with the increased incidence of metabolic bone disease. The process of bone mineral acquisition suffers some alterations during the neonatal period, including low bone mineral content at birth, insufficient mineral supply in the neonatal period, and regulatory disorders, which may compromise growth and development on the long run. The diagnosis is based on the association of risk factors, and biochemical and radiological alterations. The early intervention in the neonatal period prevents the development of severe metabolic bone disease, reducing complications during the first year of life. CONCLUSIONS: The early diagnosis of metabolic bone disease allows for early intervention, thus preventing complications that may originate from the alterations in bone mineral acquisition.