Abstract
To test whether insufficient calcium (Ca), phosphorus (P) or vitamin D (D) to support mineralization was delivered to rapidly growing VLBW (<1200g) preterm (≤30wks) infants, we retrospectively determined the intakes for weight increments (ΔX/ΔWt) of Ca, P and D for 7 infants with rickets (R) and 7 matched controls (CON). Significant differences were found between R and CON for mineral intake, but not D:
The above values represent slopes of linear regressions which have defined outer confidence limits (CL) for intakes of Ca and P. Subsequently, to test the predictive accuracy of these slopes and CL, we prospectively followed 11 VLBW infants for ΔCa/ΔWt, ΔP/ΔWt and ΔD/ΔWt. Only 1/11 developed rickets; in this baby ΔCa/ΔWt was 2.68, significantly <CON (p<0.001) and only slightly, but significantly >R (p<0.001) for the retrospective analysis. Another 1/11 had ΔP/ΔWt 2.82, which was >R but <CON; he did not get rickets. In 4/11, ΔCa/ΔWt (3.82-4.46) and ΔP/ΔWt (1.73-3.41) were <CON but >R; none developed rickets. ΔD/ΔWt was ≥CON in 11/11. Growth rates did not differ from R or CON. These data suggest that ≥3.82 mg Ca/g wt gain and ≥1.73 mg P/g wt gain, when provided primarily IV with adequate D, are sufficient to prevent rickets in growing VLBW infants. In 3 R patients under treatment, healing was diagnosed when mineral intakes reached or exceeded these values.
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Brewer, E., Winslow, C., Dell, L. et al. 518 MINERAL INTAKE IN RICKETS OF VERY LOW BIRTH WEIGHT INFANTS: RETROSPECTIVE AND PROSPECTIVE DETERMINATION OF CRITICAL INTAKES DURING GROWTH. Pediatr Res 15 (Suppl 4), 526 (1981). https://doi.org/10.1203/00006450-198104001-00531
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DOI: https://doi.org/10.1203/00006450-198104001-00531