Palabras clave
recién nacido prematuro
recién nacido de muy bajo peso
hipocalcemia
hipofosfatemia
fosfatasa alcalina
Cómo citar
Resumen
La enfermedad ósea metabólica del prematuro es una patología multifactorial que representa una importante causa de morbilidad, cuya prevalencia ha aumentado. Su diagnóstico requiere criterios bioquímicos, radiológicos y, en etapas avanzadas, clínicos; por lo cual, muchos autores recomiendan estrategias de tamizaje y prevención. El objetivo del presente artículo es realizar una revisión de los aspectos más relevantes respecto a la enfermedad ósea metabólica del prematuro, con énfasis en la prevención y tratamiento precoz. Se realizó una revisión bibliográfica con términos MeSH, en las bases de datos de Pubmed, ClinicalKey, ScienceDirect, SciELO y LILACS. Aunque no hay consenso en las pautas de tamizaje, diagnóstico y tratamiento, la principal estrategia usada en la actualidad es el soporte nutricional individualizado que cubra las demandas de calcio, fósforo y vitamina D, asociado a métodos de intervención clínica y seguimiento de bebés de alto riesgo. La comprensión de esta patología permitirá mejorar las estrategias de tamización, diagnóstico precoz, y de esta forma evitará complicaciones.
Referencias
Rustico S, Calabria A, Garber S. Metabolic bone disease of prematurity. Nutr Preterm Neonate A Clin Perspect. 2014;1(3):85–91.
Ukarapong S, Venkatarayappa SKB, Navarrete C, Berkovitz G. Risk factors of metabolic bone disease of prematurity. Early Hum Dev. 2017;112:29–34.
Abrams SA. Calcium and Vitamin D Requirements of Enterally Fed Preterm Infants. Am. Acad. Pediatr. 2013;131(5):1676–83.
Abdallah EAA, Said RN, Mosallam DS, Moawad EMI, Kamal NM, Fathallah MGED. Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity. Medicine (Baltimore). 2016;95(37):1–5.
Chin LK, Doan J, Teoh YSL, Stewart A, Forrest P, Simm PJ. Outcomes of standardised approach to metabolic bone disease of prematurity. J Paediatr Child Health. 2018;54(6):665–70.
Nallagonda S, Nallagonda M, Deorukhkar A. Metabolic bone disease of prematurity – an overview. Paediatr Child Health. 2016;27(1):14–7.
Rehman MU, Narchi H. Metabolic bone disease in the preterm infant: Current state and future directions. World J Methodol. 2015;5(3):115–21.
Chaves N, Fernández MDE. Prevención de la osteopenia del prematuro. An Pediatr Contin. 2014;12(6):336–339.
Chacham S, Pasi R, Chegondi M, Ahmad N, Mohanty SB. Metabolic bone disease in premature neonates: An unmet challenge. J Clin Res Pediatr Endocrinol. 2020;12(4):332–339.
Kavurt S, Demirel N, Yücel H, Unal S, Yıldız YT, Bas AY. Evaluation of radiologic evidence of metabolic bone disease in very low birth weight infants at fourth week of life. J Perinatol. 2021;41(11):2668–2673.
Chen W, Yang C, Chen H, Zhang B. Risk factors analysis and prevention of metabolic bone disease of prematurity. Medicine (Baltimore) 2018;97(42):e12861.
Faienza MF, D’Amato E, Natale MP, Grano M, Chiarito M, Brunetti G, et al. Metabolic bone disease of prematurity: Diagnosis and management. Front Pediatr. 2019;7(143):1–8.
Abrams SA. Management of neonatal bone health. UpToDate. 2022
Chinoy A, Mughal MZ, Padidela R. Metabolic bone disease of prematurity: Causes, recognition, prevention, treatment and long-term consequences. Arch Dis Child Fetal Neonatal Ed. 2019;104(5):F560–F566.
Kovacs CS. Bone development and mineral homeostasis in the fetus and neonate: roles of the calciotropic and phosphotropic hormones. Physiol Rev. 2014;94(4):1143–1218.
Kovacs CS. Calcium, phosphorus, and bone metabolism in the fetus and newborn. Early Hum Dev. 2015;91(11):623–628.
El-Atawi K, Kulkarni T, Abdelsamad A, Alexander L, Satyan A, Zakareya A. Metabolic bone disease in preterm babies: are we underestimating it?”. J Pediatr Neonatal Care. 2019 Mar 13;9(2):36–41
Karpen HE. Mineral Homeostasis and Effects on Bone Mineralization in the Preterm Neonate. Clin Perinatol. 2018;45(1):129–41.
Harrison CM, Gibson AT. Osteopenia in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2013;98(3):272-5.
Graça MI, Silva J, Guimarães H. Metabolic bone disease of prematurity – a report of five cases. J Pediatr Neonatal Individ Med. 2019;8(1):1-11
Tong L, Gopal-kothandapani JS, Offiah AC. Feasibility of Quantitative ultrasonography for the detection of metabolic bone disease in preterm infants — systematic review. Pediatr Radiol. 2018;48(11):1537–49.
Moreira A, Jacob R, Lavender L, Escaname E. Metabolic Bone Disease of Prematurity. Neoreviews. 2015;16(11):631–41.
Manfredini VA, Cerini C, Giovanettoni C, Brazzoduro EA, Rezzonico RM. Metabolic Bone Disease of Prematurity: A Review of Minerals Supplementation and Disease Monitoring. J Neonatal Biol. 2015;4(3):1–4.
Ognean M, Boantă O, Grădinariu G. Metabolic bone disease of prematurity. Neonatology. 2010;2(4):29–53.
Koo K, Gupta J, V N, Wilkinson M, Posen S. Skeletal changes in preterm infants. Arch Dis Child. 1982;57(2):447–52.
Figueras-Aloy J, Álvarez-Domínguez E, PérezFernández JM, Moretones-Suñol G, Vidal-Sicart S, Botet-Mussons F. Metabolic bone disease and bone mineral density in very preterm infants. J Pediatr. 2014;164(3):499–504.
Misra M, Pacaud D, Petryk A, Collett-solberg PF, Kappy M. Vitamin D Deficiency in Children and Its Management : Review of Current Knowledge and Recommendations. 2008;122(2):398–417.
Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. Enteral nutrient supply for preterm infants: Commentary from the european society of pediatric gastroenterology, hepatology and nutrition committee on nutrition. J Pediatr Gastroenterol Nutr. 2010;50(1):85–91.
So KW, Ng PC. Treatment and prevention of neonatal osteopenia. Curr Paediatr. 2005;15(2):106–13.
Milinarsky A, Fischer S, Giadrosich V, Torres M T, Arriagada M, Arinoviche R, et al. Normalización de la densidad mineral ósea en niños nacidos prematuros en Viña del Mar, Chile. Rev Med Chil. 2007;135(12):1546–50.
Kwok TC, Dorling J, Gale C. Early enteral feeding in preterm infants. Semin Perinatol. 2019;43(7). 151159
Loomis T, Byham-Gray L, Ziegler J, Parrott JS. Impact of standardized feeding guidelines on enteral nutrition administration, growth outcomes, metabolic bone disease, and cholestasis in the NICU. J Pediatr Gastroenterol Nutr. 2014;59(1):93–8.
Shulhan J, Dicken B, Hartling L, Larsen BM. Current knowledge of necrotizing enterocolitis in preterm infants and the impact of different types of enteral nutrition products. Adv Nutr. 2017;8(1):80–91.
Moore TA, Wilson ME. Feeding intolerance: A concept analysis. Adv Neonatal Care. 2011;11(3):149–54.
Mimouni FB, Mandel D, Lubetzky R, Senterre T. Calcium, phosphorus, magnesium and vitamin D requirements of the preterm infant. World Rev Nutr Diet. 2014;110(1):140–51.
Bozzetti V, Tagliabue P. Metabolic bone disease in preterm newborn: An update on nutritional issues. Ital J Pediatr. 2009;35(20): 1-8.
Schulzke SM, Kaempfen S, Trachsel D, Patole SK. Physical activity programs for promoting bone mineralization and growth in preterm infants. Cochrane Database Syst Rev. 2007;2(1):1 - 28.
Eliakim A, Litmanovitz I ND. The Role of Exercise in Prevention and Treatment of Osteopenia of Prematurity: An Update. Pediatr Exerc Sci. 2017;29(4):450–455.
Field T, Diego M, Hernández-Reif M. Preterm Infant Massage Therapy Research: A Review Tiffany. Inf
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