Abstract
During the first 72 hrs of life, 30% of premature (≤37wks) develop HC. Possible sequelae of early HC have not been examined. Twelve well AGA prematures were studied in matched pairs (gestation and Apgar) and given prophylactic doses of 1, 25 dihydroxyvit 03 (l,25(OH)2D3 - the active D metabolite), or vit D2 400 IU(controls) during the first 3 days. Infants were studied prospectively for degree of tremors on day 1, 2, 3; Brazelton Behavior Assessment (BBA) at 40wks postconception; and Gesell Developmental Exam at 3 & 6 mos. Exams were blinded to ionized Ca (ICa, Orion SS-20) and treatment group. All prestudy iCa were <3.5mg%. By 48hrs, the 1,25(OH)2D3 group had significantly higher iCa, 3.6±0.1mg% (mean±SEM) vs 3.2±0.1 at 12 hrs (paired t, p<.05); controls did not change. Degree of tremors was not related to iCa. Controls were less responsive to BBA orientation (visual, auditory and combined) items than 1, 25(OH)2D3 group, 4.1±.16vs 5.0±.21(t test, p<.01). The 3 mo Gesell was lower for controls vs 1, 25(OH)2D3, 89±3 vs 99±4 (p<.06) and was 110±1 vs 116±1 at 6 mo (p<.01). Eight of the 12 infants were rematched blindly in pairs for Apgar, gestation and HC at 48 hrs vs normocalcemia (NC). HC infants appeared less responsive than NC in the BBA visual-auditory item, 5±0.6 vs 6±.4 (Wilcoxon-Mann, p<.07), to need more consoling (6.6±0.3 vs 7.6±.4, p<.10) and to be more excitable (5.6±.3 vs 6.3±.4, p<.10). No differences were found between HC and NC in 386 mo Gesell. Early neonatal hypocalcemia appears to have an effect on the newborn's ability to respond to social(orientation) stimuli; long term sequelae are uncertain.
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Chan, G., Chan, M., Tsang, R. et al. NEUROLOGIC DEVELOPMENT OF PREMATURES TREATED FOR NEONATAL HYPOCALCEMIA(HC). Pediatr Res 11, 561 (1977). https://doi.org/10.1203/00006450-197704000-01145
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DOI: https://doi.org/10.1203/00006450-197704000-01145