Mutlu Mehmet, Aktürk-Acar Filiz, Kader Şebnem, Aslan Yakup, Karagüzel Gülay
Department of Neonatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
Department of Pediatric Endocrinology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
Am J Perinatol. 2023 Apr;40(5):519-524. doi: 10.1055/s-0041-1729559. Epub 2021 May 11.
The study aimed to analyze the risk factors and clinical features of metabolic bone disease of prematurity (MBDP) in premature infants compared with infants of similar gestational age and birth weight without MBDP.
This retrospective case-control study was performed by comparing 81 cases of MBDP with 63 controls to identify potential risk factors. Premature infants with a gestational age ≤33 weeks and birth weight <1,500 g were included. Medical records were examined in terms of maternal conditions, potential risk factors, and clinical characteristics.
Bone fractures and invasive ventilator dependence were the most common clinical features of MBDP. Duration of invasive ventilation and total mechanical ventilation days, necrotizing enterocolitis, corticosteroid use, anticonvulsive drug use, duration of dexamethasone and caffeine use, total parenteral nutrition, and length of hospitalization were significantly higher in neonates with MBDP ( < 0.05). Breastfed neonates and those receiving human milk fortifier had a lower incidence of MBDP than those premature formula or mixed feeding ( < 0.05). Anticonvulsive drug use (odds ratio: 2.935; 95% confidence interval: 1.265-6.810) was identified as a risk factor for MBDP at multiple regression analysis.
Our results show that anticonvulsive drug use is a significant risk factor for the development of MBDP. If long-term use is not required, anticonvulsive drugs should be stopped as soon as possible. Further studies involving patients with MBDP are required to determine the risk factors and clinical features.
· MBDP is a multifactorial disorder.. · Anticonvulsive drug use is an important risk factor for the development of MBDP.. · Bone fractures and invasive ventilator dependence are the most common clinical features of MBDP..
本研究旨在分析早产儿代谢性骨病（MBDP）的危险因素和临床特征，并与胎龄和出生体重相似但无MBDP的婴儿进行比较。
本回顾性病例对照研究通过比较81例MBDP病例和63例对照来确定潜在危险因素。纳入胎龄≤33周且出生体重<1500g的早产儿。对产妇情况、潜在危险因素和临床特征进行病历检查。
骨折和有创通气依赖是MBDP最常见的临床特征。MBDP新生儿的有创通气持续时间和总机械通气天数、坏死性小肠结肠炎、使用皮质类固醇、使用抗惊厥药物、地塞米松和咖啡因使用时间、全胃肠外营养和住院时间显著更高（<0.05）。母乳喂养的新生儿和接受母乳强化剂的新生儿MBDP发病率低于使用早产配方奶或混合喂养的新生儿（<0.05）。在多因素回归分析中，使用抗惊厥药物（比值比：2.935；95%置信区间：1.265 - 6.810）被确定为MBDP的一个危险因素。
我们的结果表明，使用抗惊厥药物是MBDP发生的一个重要危险因素。如果不需要长期使用，应尽快停用抗惊厥药物。需要对MBDP患者进行进一步研究以确定危险因素和临床特征。
· MBDP是一种多因素疾病。· 使用抗惊厥药物是MBDP发生的一个重要危险因素。· 骨折和有创通气依赖是MBDP最常见的临床特征。
