Objective To analyze factors related to bone metabolism indicators in premature infants, so as to provide clinical evidence for early detection and prevention of neonatal metabolic bone disorders. Methods A total of 189 preterm infants who met the inclusion criteria from January 1st to December 1st, 2022, at the Northwest Women's and Children's Hospital were collected for retrospective analysis. The correlations of gestational age, birth weight with bone metabolism indicators at birth was analyzed, including serum calcium, phosphorus, 25(OH)D, alkaline phosphatase (ALP). For high-risk groups of metabolic bone disease of preterm (MBDP) infants (gestational age <32 weeks), the impact of different perinatal factors on the levels of serum calcium, phosphorus, 25(OH)D, and ALP at birth was analyzed. Results Serum calcium in preterm infants was positively correlated with gestational age and birth weight (r=0.364, 0.311, P<0.05), while serum ALP was negatively correlated with gestational age and birth weight (r=-0.294,-0.261, P<0.05), and serum phosphorus was positively correlated with birth weight (r=0.186, P<0.05). In the study of high-risk MBDP groups (gestational age <32 weeks), the serum phosphorus levels in the cesarean section group, IUGR group, asphyxia/low Apgar score group, and pregnancy-induced hypertension group were lower than those in the natural labor group, non-IUGR group, non-asphyxia/low Apgar score group, and non-pregnancy-induced hypertension group (t=2.128, 4.718, 2.543, 4.134, P<0.05). ALP in the IUGR group and pregnancy-induced hypertension group was lower than that in the non-IUGR group and non-pregnancy-induced hypertension group (Z=-1.846,-2.844, P<0.05); serum 25(OH)D level in the gestational diabetes group was higher than that in the non-gestational diabetes group (Z=-2.410, P<0.05). Multiple linear regression analysis suggested that IUGR wassignificantly associated with serum phosphorus level in high-risk infants (β=-0.231, P<0.05), and pregnancy-induced hypertension wassignificantly associated with ALP level(β=-60.360, P<0.05). Conclusions Bone metabolism markers in preterm infants are significantly correlated with gestational age and birth weight. For high-risk MBDP infants (gestational age < 32 weeks), IUGR is an risk factor for abnormal serum phosphorus levels, and hypertensive disorders of pregnancy are influencing factors for reduced ALP levels. Targeted interventions based on maternal conditions are recommended to reduce the incidence of MBDP.
Key words
birth weight /
gestational age at birth /
metabolic bone disease of prematurity
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