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- Title
A severe case of osteopenia of prematurity.
- Authors
Dan, Adriana Mihaela; Vasilescu, Diana Iulia
- Abstract
Osteopenia of prematurity (OP) – also called metabolic bone disease (MBD) or rickets of prematurity – is a late complication of preterm birth, consisting of decreased bone mineralization in patients with low gestational age and birth weight. The disease can be expressed in various degrees of severity, mostly mild. The real incidence of the disease is not known due to the lack of international consensus regarding its definition, but it is approximated at 50% of babies under 1000 g. Despite the actual knowledge about its physiopathology and advances in the nutritional strategies for very-low-birth-weight (VLBW) infants, osteopenia of prematurity is still present, probably underestimated. Most of the times, no specific signs or symptoms are identified. If present, these are represented by growth and length deficits, signs of classical rickets, respiratory distress syndrome, or difficulty to wean from ventilatory support, due to impaired thoracic compliance. The risk factors for an increased gravity of OP are both prenatal and postnatal, and the genetic predisposition could be involved. We report the case of a 24- week gestation ELBW baby with a complicated clinical course, involving respiratory, neurologic, cardiovascular and digestive alterations, who was diagnosed at 5 months of age with a severe osteopenia of prematurity expressed as multiple subsequent fractures which raised problems of differential diagnosis and management. The retrospective case analysis showed that a combined effect of prenatal and postnatal risk factors (extreme prematurity, maternal chorioamnionitis, prolonged TPN, use of corticotherapy, methylxanthines, diuretics, immobilization and sedation) have conducted to the extreme severity of the disease in our patient. This article intends to emphasize the importance of surveillance of the nutritional status of both mother and infant. The correct pregnancy monitoring and promoting an aggressive nutritional strategy for extremely-low-birth-weight infants could prevent an aggressive course of the disease and poor long-term outcomes.
- Subjects
OSTEOPENIA; METABOLIC bone disorders; RESPIRATORY distress syndrome; CHORIOAMNIONITIS; SYMPTOMS; MOTHER-infant relationship
- Publication
Obstetrică şi Ginecologie, 2022, Vol 70, Issue 1, p40
- ISSN
1220-5532
- Publication type
Article
- DOI
10.26416/OBSGIN.70.1.2022