Prolonged Effects of COVID-19-Related Behavioral Restrictions on Neonatal Bone Metabolism: A Retrospective Study.

OBJECTIVES

The COVID-19 pandemic introduced significant lifestyle changes, such as reduced outdoor activities, social distancing, and other public health measures. These changes may have affected maternal health and neonatal biochemical parameters linked to bone metabolism. This retrospective study aimed to evaluate the impact of pandemic-related behavioral restrictions on neonatal biochemical markers, including calcium, phosphate, magnesium, intact parathyroid hormone (iPTH), and alkaline phosphatase (ALP), measured on the first day of life across three distinct time periods (pre-COVID-19, COVID-19 pandemic, and post-COVID-19).

MATERIALS AND METHODS

This retrospective cohort study included 964 neonates admitted to a Japanese neonatal intensive care unit between 2018 and 2024. Neonates were categorized into three groups: pre-COVID-19 (2018-2020), COVID-19 pandemic (2020-2022), and post-COVID-19 (2022-2024) periods. Serum biochemical parameters were measured on the first day of life and compared statistically among the groups.

RESULTS

There were no significant differences in gestational age and birth weight among the three groups. Serum phosphate levels demonstrated a significant, stepwise increase across the periods (pre-COVID-19: 5.4 (4.8-5.9) mg/dL, COVID-19 pandemic: 5.6 (5.0-6.1) mg/dL, post-COVID-19: 5.7 (5.2-6.4) mg/dL; p<0.01). Magnesium levels significantly decreased in the post-COVID-19 period (pre-COVID-19: 2.05 (1.9-2.3) mg/dL, post-COVID-19: 1.90 (1.8-2.2) mg/dL; p<0.01). No significant changes were observed in calcium, iPTH, or ALP levels.

CONCLUSIONS

Pandemic-related lifestyle changes caused significant and persistent alterations in neonatal phosphate and magnesium metabolism, necessitating continuous monitoring and preventive strategies to address long-term health impacts.