Clinical high-risk factors of metabolic bone disease in very low birth weight infants

Objective To explore the high-risk factors of metabolic bone disease(MBD)in premature infants by retrospective analysis of the clinical data so as to provide evidence for optimal clinical management. Methods Clinical data of premature infants with birth weight 500 IU/L and blood phosphorus <1.5 mmol/L were selected as MBD group and premature infants with birth weight <1 500 g were selected randomly as non-MBD group. General data, pulmonary surfactant, continuous positive airway pressure, mechanical ventilation, start time of enteral nutrition, parenteral nutrition (PN) time, breast feeding time and breast milk fortifier adding, drug usage, hospitalization time and complications were recorded and compared between the two groups. Results A total of 440 premature infants with birth weight <1 500 g were admitted to the hospital during the study period. 58[13.2%(58/440)] infants were enrolled in the MBD group, among which infants with birth weight <1 000 g accounting for 56.9%(33/58). High birth weight (OR=0.62, 95% CI: 0.389-0.990) was an independent protective factor of MBD in premature infants. The higher the birth weight, the lower the risk of MBD in premature infants. The longer duration of breast feeding time(OR= 2.191, 95% CI: 1.628-2.950), later initial time of enteral feeding(OR=2.695, 95% CI: 1.710-4.248), longer duration of PN(OR=6.205, 95% CI: 3.359-11.463) time, longer duration of respiratory supporting time(OR=1.046, 95% CI: 1.026-.067), longer hospital stay time(OR=1.703, 95% CI: 1.109-2.615) and small for gestational age(OR=2.965, 95% CI: 1.163-5.658) were independent risk factors of MBD in premature infants. The duration of PN was the most important independent risk factor of MBD in premature infants(OR=6.205, 95% CI: 3.359-11.463). Conclusion Multiple factors can lead to MBD of premature infants. The high birth weight is an independent protective factor of MBD and the duration of PN is the most important independent risk factor of MBD in premature infants. Key words: Premature infant; Metabolic bone disease; High risk factor