chapter  7
30 Pages

Hypophosphatemia and Bone Disease in the Neonatal Intensive Care Unit

Neonatal rickets, rickets of prematurity, osteopenia of prematurity, and phosphate depletion syndrome of the newborn are all terms used to refer to pathophysiologic changes characterized by the failed progression of normal mineralization of bone and epiphyseal cartilage in the newborn. Once birth has severed the neonate from his intrauterine mineral supply, the newborn's gastrointestinal tract must adjust to absorb the minerals and nutrients needed to continue with normal development. Healthy, term infants with adequate substrate availability typically have no difficulty in making this transition. Others, however, with any combination of premature birth, low birthweight, inadequate mineral supply, or a disease state requiring intensive interventional therapy are at risk of falling beind in mineral accretion to the point of evident bone pathology.