J Korean Med Sci.  2012 Dec;27(12):1552-1555. 10.3346/jkms.2012.27.12.1552.

High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

• Lee SM
• Namgung R
• Park MS
• Eun HS
• Park KI
• Lee C

• KMID: 2157981
• DOI: http://doi.org/10.3346/jkms.2012.27.12.1552

Abstract

Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 +/- 16.1 days of age, and improved by 85.3 +/- 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

Keyword

Cholestasis; Bronchopulmonary Dysplasia; Risk Factors; Rickets; Infant, Extremely Low Birth Weight

MeSH Terms

Alkaline Phosphatase/blood
Birth Weight
Bronchopulmonary Dysplasia/*etiology
Case-Control Studies
Cholestasis/*etiology
Female
Gestational Age
Humans
Incidence
Infant
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature
Male
Parenteral Nutrition/*adverse effects
Regression Analysis
Retrospective Studies
Rickets/enzymology/*epidemiology/radiography
Risk Factors
Severity of Illness Index
Alkaline Phosphatase

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