The effect of calcium and phosphorus supplements on bone mass and serum alkaline phosphatase in premature infants

Background:Osteopenia is common problem in premature infants. Low-birth weight babies do not receive adequate amounts of calcium and phosphorus through breast feeding. This study examines the effect of calcium and phosphorus supplements on osteopenia in premature infants.

Methods: This clinical trial included 42 premature infants hospitalized at Razi hspital in Kermanshah. All the babies had a birth weight of less than 1800 grams. They were assigned into two groups of control and case. While babies in the control group received only breast milk, calcium (80mg/kg/day) and phosphorus (40mg/kg/day) were added to the breast milk for the infants in the other group. All the infants received a daily supplement of 400 iu vitamin D. Anthropometric measurements, serum calcium, phosphorus, and alkaline phosphatase concentration were examined once at the beginning of the study and then every two weeks until week 6. At the end of the period, wrist x – ray was administered for all the infants. Data were then analyzed using t-student and chi square.

Results: Radiographic criteria did not indicate any signs of osteopenia. Yet a significantly higher serum alkaline phosphatase concentration was revealed through biochemical analysis in control group (p=0.001). Anthropometric measurements showed improvements in height, weight and head circumference for the two groups.

Conclusion: Treatment with calcium and phosphorus supplements was associated with a decrease in serum alkaline phosphatase concentration which is an indication of osteopenia. However the treatment did not reduce incidence of osteopenia in premature infants.