Vol. 2, Issue 1, Part A (2020)

Introduction: Every year, 15 million babies are born prematurely around the world of which more than 1 million die as a result of prematurity. Premature infants are considered to be at high risk for developing osteopenia due to their reduced bone mineral content. Mothers milk containing 25-35 mg/dl of calcium and 10-15 mg/dl of phosphorus simply does not contain enough minerals to support skeletal growth of growing premature infants. Supplement of calcium and phosphorus along with breast milk can reduce the rate of osteopenia and improve the growth of premature infants. Objective of the study: To determine the efficacy of calcium and phosphorus supplementation for prevention of metabolic bone disease and improvement of growth in preterm infants. Methodology: A randomized clinical trial study was conducted at Department of Neonatology, BSMMU, from 16^th August 2016 to 27^th August 2017. It involved monitoring 50 premature neonates over a period of six weeks. The babies who were fed with breast milk were randomly divided into two equal groups. One group received supplement of calcium and phosphorus along with breast milk. Serum calcium, phosphorus and alkaline phosphatase levels as well as growth parameters (including weight, length, and head circumference) were measured at enrollment and at 6 weeks post birth. At the end of 6 weeks, wrist X-ray was done for evaluation of osteopenia. Data was analyzed using SPSS 20. Results: Radiological and biochemical evidence of metabolic bone disease were found in 6 (28%) supplemented group and 7 (35%) non-supplemented group (p=0.45). S. calcium, S. inorganic phosphate and S. alkaline phosphatase level were comparable at enrollment between two groups. At 6 weeks S. calcium, S. inorganic phosphate level were more and S. alkaline phosphatase level were less in supplemented group but no significant change was observed between two groups. The mean of weight, length and head circumference were also comparable at enrollment between two groups. At 6 weeks’ growth velocity considering weight, length and head circumference were more at supplemented group but no significant change were observed between two groups. Conclusion: Infants of supplemented group showed better growth velocity and lower incidence of metabolic bone disorders than non-supplemented group. But this difference between supplemented group and non-supplemented group were not statistically significant. However, his study does not provide any evidence to suggest the effectiveness of supplementary calcium and phosphorus in osteope