Abstract
DXD was used to measure BMC in preterm infants ≤ 30 weeks gestational age (GA) fed formula milk complying with recommended guidelines for calcium (Ca) and phosphorus (P) content and ratio. DXD images were obtained at 48 hours of age and at weekly or 2 weekly intervals until term. Results from 9 infants are available. Mean (± SD) BMC at birth was 2.7 (± 1.5) mg/mm and at 6 weeks postnatal age (PNA) was 2.0 (± 0.5) mg/mm. 5 babies studied at term had a mean (± SD) EMC of 3.7 (± 1.1) mg/mm. The expected EMC of newborn infants of this GA range is 3.2 (± 0.6) mg/mm and of newborn infants at term is 9.2 (± 1.8) mg/mm1.
One infant developed a fracture of the femur. His BMC fell from 2.3 mg/mm to 0.8 mg/mm in the first week of life and was 0.2 mg/mm at 8 weeks PNA. The fracture was detected at 14 weeks PNA at which time the BMC was 3.3 mg/mm.
We conclude that BMC did not increase in these babies as it does in utero and at term was well below the expected value. Risk of fracture may be predicted from very low BMC. Supplementation of formula milk with Ca and P may not be sufficient to improve mineralisation and other factors must be investigated.
1Greer et al 1983, Ped Res 17: 259–262.
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Aylett, S., Doran, M., Chan, F. et al. Dual energy densitometry (EKD) measurement of bone mineral content (EMC) in preterm babies. Pediatr Res 26, 507 (1989). https://doi.org/10.1203/00006450-198911000-00047
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DOI: https://doi.org/10.1203/00006450-198911000-00047
