Calcium and Phosphorus Intake in Very Low Birth Weight Preterm Infants: Implications for Osteopenia Prevention and Growth

Abstract

Purpose: Sufficient calcium and phosphorus supplementation in preterm infants may ensure proper bone growth and reduce the risk of osteopenia. This study aimed to assess—in comparison to controls—the calcium and phosphorus intake via both enteral and parenteral routes, as well as growth, of preterm infants with very low birth weight (VLBW) who were diagnosed with osteopenia. Assessment took place during the first 28 days of life; infants were followed throughout hospitalization. Methods: We conducted a single-center, retrospective study of preterm infants weighing <1,500 g who were admitted to a tertiary healthcare center between January 1, 2017 and June 30, 2022. Results: The study included 55 infants with osteopenia (case group) and 220 control infants (control group). The average weekly calcium intake in the case group during the first 4 weeks after birth was significantly lower than that of the control group, with values of 1.45, 1.98, 3.06, and 4.02 mEq/kg/day versus 1.64, 3.10, 4.89, and 5.69 mEq/kg/day, respectively (p<0.05). Similarly, phosphorus intake was significantly lower in the case group (0.75, 1.24, 1.29, and 1.45 mmoL/kg/day) compared to the control group (0.75, 1.38, 1.62, and 1.79 mmoL/kg/day; p<0.05). Preterm infants with VLBW and osteopenia exhibited lower average daily weight gain (19.03 g vs. 21.45 g; p<0.001) and a smaller gain in head circumference (0.57 cm vs. 0.68 cm; p<0.001) compared to controls. Conclusion: This findings highlight the necessity for timely provision of calcium and phosphorus to prevent osteopenia and promote optimal growth in this vulnerable population.