Risk factors of metabolic bone disease of prematurity

Abstract

ObjectiveTo identify the factors that increase risk of metabolic bone disease of prematurity (MBD). Study designA retrospective case-control study of infants born between January 2013–April 2014 with gestation age <30weeks and birth weight <1000g. MBD was defined as serum alkaline phosphatase above 500U/L and characteristic radiographic changes. Information was obtained on the presence of specific comorbidities. ResultsOf 76 infants evaluated, 40 met criteria for MBD. Median gestational age was 25weeks in both groups (p=0.512). Median birth weight of infants with MBD was significantly lower than that of controls (560 vs. 765g, p<0.01). Longer period of parenteral nutrition and dexamethasone use was observed in MBD group. Cholestasis was associated with the highest likelihood of MBD (OR 16.6, 95% CI 4.8–56.9). Seizures (OR 5.2, 95% CI 1.3–20.5) and the prolonged use of diuretics (OR 2.6, 95% CI 1.0–7.0) also significantly increased the likelihood of MBD. Only cholestasis remained significant (OR 9.6, 95% CI 2.1–45.3) after multiple regression analysis. ConclusionCholestasis is a significant risk factor for the development of MBD. Our future studies will be directed towards determining the causal relationship between cholestasis and MBD.