Associated neonatal and maternal factors of osteopenia of prematurity in low resource setting: A cross-sectional study

Dina Angelika; Risa Etika; Muhammad Pradhika Mapindra; Martono Tri Utomo; Paulus Rahardjo; I Dewa Gede Ugrasena

doi:10.1016/j.amsu.2021.102235

Associated neonatal and maternal factors of osteopenia of prematurity in low resource setting: A cross-sectional study

Ann Med Surg (Lond). 2021 Mar 26:64:102235. doi: 10.1016/j.amsu.2021.102235. eCollection 2021 Apr.

Authors

Dina Angelika¹, Risa Etika¹, Muhammad Pradhika Mapindra¹, Martono Tri Utomo¹, Paulus Rahardjo², I Dewa Gede Ugrasena¹

Affiliations

¹ Department of Child Health, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
² Department of Radiology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Abstract

Objective: Determining neonatal and maternal factors that are associated with the incidence of OFP.

Methods: This study employed a cross-sectional design, in which the participants were identified for clinical variables (sex, gestational age, birth weight, etc.), neonatal morbidity (sepsis, necrotizing enterocolitis (NEC), etc.), and maternal risk factors (premature rupture of membranes, preeclampsia, etc.). The data were analyzed using Chi-square test, independent t-test, and logistic regression test with p < 0.05.

Results: The birth weight ranged from 800 to 1495 g (1219 ± 225 g), of which 5 newborns (17%) were <1000 g. The gestational age ranged from 27 to 32 weeks, with a mean of 29 ± 1.5 weeks. The signs of OFP were observed in 13 (43%) infants, of which 2 (15%) OFP infants had a birth weight <1000 g. There was significant difference in parenteral nutrition duration (p = 0.018), onset of vitamin D supplementation (p = 0.019), and ALP level (p = 0.012) of infants between the OFP group and the non-OFP group. The variables associated with the incidence of OFP were parenteral nutrition duration >15 days (OR = 5.4; 95% CI 1.120-26.044; p = 0.036), ALP level >500 U/L (OR = 2.889; 95% CI 1.703-4.900; p = 0.014), and PROM (OR = 5.4; 95% CI 1.039-28.533; p = 0.045).

Conclusion: The lack of phosphate intake, prolonged parenteral nutrition, ALP level >500 U/L, onset of vitamin D supplementation, and premature rupture of membranes are associated with the incidence of OFP.

Keywords: Incidence; Infant factor; Maternal factor; Osteopenia; Premature.