Document Detail

Results of extremely-low-birth-weight infants randomized to receive extra enteral calcium supply.
MedLine Citation:
PMID:  21865980     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Bone mineral deficiency continues to occur in extremely-low-birth-weight (ELBW) infants despite formulas enriched in calcium (Ca) and phosphorus (P). This study tested whether extra enteral Ca supplementation increases bone mineral content (BMC) and prevents dolichocephalic head flattening and myopia in ELBW infants.
STUDY DESIGN: Infants 401 to 1000 birth weight receiving enteral feeds were randomized to receive feeds supplemented with Ca-gluconate powder or pure standard feeds. The main outcome measures were the excretion of Ca and P by weekly spot urine measurements, the degree of dolichocephalic deformation (fronto-occipital diameter to biparietal diameter ratio, FOD/BPD) at 36 weeks postmenstrual age, and the BMC (by dual-energy x-ray absorptiometry) at discharge. Cycloplegic refraction was measured at 18 to 22 months corrected age.
PATIENTS AND RESULTS: Ninety-nine ELBW infants with a gestational age of 26 weeks (23-31) (median [minimum-maximum]) were randomized at a postnatal age of 12 days (5-23) weighing 790 g (440-1700). Urinary Ca excretion increased and P excretion decreased in the Ca-supplemented group. Total BMC was 89.9 ± 2.4 g (mean ± SE) in the supplemented group and 85.2 ± 2.6 g in the control group (P = 0.19). The FOD/BPD was 1.50 (1.13-1.69, mean ± SD [standard deviation]) and 1.47 (1.18-1.64) in the supplemented and control groups, and the refraction 0.98  ± 1.23 and 1.40 ± 1.33 dpt (P = 0.68), respectively in 64 ELBW infants (79% of survivors) at 2-year follow-up.
CONCLUSIONS: Extra enteral Ca supplementation did not change BMC, head shape, or refraction. The decreased P excretion may reflect P deficiency in infants receiving extra Ca, preventing improved bone mineral accretion.
William F Carroll; Jorge Fabres; Tim R Nagy; Marcela Frazier; Claire Roane; Frank Pohlandt; Waldemar A Carlo; Ulrich H Thome
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  53     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-25     Completed Date:  2011-12-22     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-45     Citation Subset:  IM    
Miami Children's Hospital, Miami, Florida, USA.
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MeSH Terms
Absorptiometry, Photon
Bone Density / drug effects*
Calcium / deficiency
Calcium Gluconate / administration & dosage
Calcium, Dietary / administration & dosage*
Case-Control Studies
Dietary Supplements*
Enteral Nutrition
Follow-Up Studies
Infant, Extremely Low Birth Weight / metabolism*
Infant, Newborn
Phosphorus / deficiency
Grant Support
Reg. No./Substance:
0/Calcium, Dietary; 299-28-5/Calcium Gluconate; 7440-70-2/Calcium; 7723-14-0/Phosphorus

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