Clinical analysis and follow-up observation of eight cases of premature infants with metabolic bone disease complicated with spontaneous fracture
10.3760/cma.j.issn.1673-4912.2025.09.008
- VernacularTitle:早产儿代谢性骨病合并自发性骨折八例临床分析及随访观察
- Author:
Liang TANG
1
;
Xin XIE
1
;
Fan WU
1
Author Information
1. 广州医科大学附属第三医院新生儿科 广东省产科重大疾病重点实验室 广东省妇产疾病临床医学研究中心 粤港澳母胎医学高校联合实验室，广州 510150
- Publication Type:Journal Article
- Keywords:
Metabolic bone disease;
Spontaneous fracture;
Premature infants;
Clinical characteristics;
Follow-up
- From:
Chinese Pediatric Emergency Medicine
2025;32(9):679-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics and follow-up data of premature infants with metabolic bone disease（MBDP）complicated with spontaneous fracture，and to provide a reference for clinical diagnosis and treatment.Methods:The clinical characteristics,physical growth,and development of eight premature infants with MBDP and spontaneous fracture admitted to the Neonatology Department of the Third Affiliated Hospital of Guangzhou Medical University from January 2020 to December 2022 were retrospectively analyzed.Results:Among the eight cases，six were male and two were female，with gestational ages ranging from 24 +6 to 28 +5 weeks and birth weights ranging from 495 to 1 070 grams.They were complicated with multiple serious complications associatied with premature birth.All patients had a history of drug use,including glucocorticoids,diuretics，caffeine,or sedation，as well as prolonged mechanical ventilation,parenteral nutrition，and multiple blood transfusions.During hospitalization，the normal blood calcium was monitored in all eight premature infants，and the blood phosphorus levels were all below 1.8 mmol/L，serum alkaline phosphatase（ALP）levels exceeded 500 IU/L，with five cases exceeding 900 IU/L.The diagnostic time of MBDP ranged from 61 to 157 days after birth.All premature infants were complicated with fractures of different parts，and the diagnostic time of fractures ranged from 74 to 157 days after birth.They were actively treated with calcium，phosphorus and vitamin D，and were discharged from the hospital after the fracture recovery.The hospitalization time was 95 to 226 days.At discharge，six premature infants had retarded growth in body length and/or weight，and four premature infants still had retarded growth to varying degrees at the correct gestational age of 12 months. Conclusion:Early screening and prevention of MBDP should be carried out in extremely and very premature infants to prevent the occurrence of spontaneous fractures.Furthermore,follow-up management and monitoring after discharge should be strengthened to improve their prognosis.
