الفهرس | Only 14 pages are availabe for public view |
Abstract Osteopenia of prematurity is a disease which affects preterm infants due to early extra uterine life & many risk factors to which preterm infants are exposed in the incubator such as, delayed enteral feeding, prolonged immobilization, prolonged periods of total parenteral nutrition with insufficient mineral intake compared to the transplacental mineral supply from the mother during intrauterine life. Prevention of such disease is very important to avoid bone fracture & childhood bone complications. Prevention could be achieved by avoidance of risk factors & proper mineral supply with proper calories. The present study was designed to evaluate effect of prolonged use of caffeine therapy on bone mineral density in preterm neonates. 42 preterm infants, were enrolled in our study. They were randomized into 2 groups; 20 preterm infants as a non-caffeine group did not receive caffeine and 22 preterm infants as a caffeine-group received caffeine therapy. Both groups received the same dose of parenteral calcium by intermittent injection. All neonates included in this study were subjected to: Full history taking and complete clinical assessment together with serum calcium, phosphorus, alkaline phosphatase, sodium, potassium, creatinine, x-ray, abdominal ultrasound & DEXA scan. The results of the current study revealed that: There was no statistical significant difference between the two studied groups as regard body weight at the time of discharge. There was non statistical significant difference between the two studied groups in the pretreatment levels of the serum Ca, P, Mg, ALP, Cr, Na and K. There was significant increase in serum ALP a day before discharge in the caffeine group compared to non-caffeine group. ALP significantly increased in patients who received caffeine therapy > 14 compared to duration ≤ 14 days. There was non statistical significant difference between the two studied groups in the pretreatment levels of the serum Ca, P, Mg, Cr, Na and K a day before discharge. BMC significantly decreased in the caffeine compared to non-caffeine group. BMC significantly decreased in patients who received caffeine therapy > 14 days compared to duration ≤ 14 days. BMC highly significantly decreased in patients who received caffeine therapy > 14 days compared to non-caffeine group.There was non statistical significant difference in BMD in the two studied groups. There was non statistical significant difference in fracture in the two studied groups and no one in the studied groups developed nephrocalcinosis. There was negative correlation between BMC and alkaline phosphatase and a positive correlation between BMC and the serum phosphorus level. BMD has a negative correlation with alkaline phosphatase and a positive correlation with the serum phosphorus level after caffeine therapy. There is negative correlation between duration of caffeine therapy and BMC and a negative correlation between cumulative dose of caffeine therapy and BMD. |