{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T17:47:53Z","timestamp":1757699273024},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the current protocol of metabolic bone disease (MBD) at three Monash Health neonatal units (Melbourne, Australia).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective audit of 171 infants born at &lt;32 weeks' gestation over 18 months. Mean gestational age was 28.6 \u00b1 2.1 weeks, and birthweight was 1190 \u00b1 374 g. Risk factors of MBD include intra\u2010uterine growth retardation (<jats:italic>n<\/jats:italic> = 33, 19.3%), maternal pre\u2010eclampsia (<jats:italic>n<\/jats:italic> = 17, 9.9%), necrotising enterocolitis (<jats:italic>n<\/jats:italic> = 9, 5.4%) and medications like methylxanthines (94.2%; mean 54.8 days), diuretics (38.6%; mean 49.2 days) and glucocorticoids (5.3%; mean 35 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 84.8% infants had an initial MBD screen (mean age 36.3 days), with 45% having repeated monitoring (mean age 71.9 days), and 14.2% had initial alkaline phosphatase levels &gt;500 U\/L, decreasing to 10.1% on follow\u2010up. All infants received additional vitamin D supplementation of 400 IU\/day, phosphate of 25.1% (<jats:italic>n<\/jats:italic> = 43) and calcium of 19.9% (<jats:italic>n<\/jats:italic> = 34). Fractures were identified from clinical documentation in 2.9% (<jats:italic>n<\/jats:italic> = 5) of infants. Stratifying into phosphate\u2010treated and untreated groups revealed significant differences (<jats:italic>P<\/jats:italic> &lt; 0.001) for gestational age and birthweight: 26.7 \u00b1 1.7 weeks\/918 \u00b1 272 g for treated versus 29.2 \u00b1 1.9 weeks\/1283 \u00b1 359 g for untreated. In the phosphate\u2010treated group, improvement was seen in mean alkaline phosphatase (pre\u2010treatment 467 \u00b1 204 U\/L and post\u2010treatment 342 \u00b1 221 U\/L, <jats:italic>P<\/jats:italic> &lt; 0.01) and mean phosphate levels (1.8 \u00b1 0.4 vs. 2.2 \u00b1 1.0 mmol\/L, <jats:italic>P<\/jats:italic> &lt; 0.01). Linear growth difference between phosphate\u2010treated (<jats:italic>n<\/jats:italic> = 10) and untreated groups (<jats:italic>n<\/jats:italic> = 24) was insignificant at &gt;6 months of age (<jats:italic>P<\/jats:italic> = 0.13), although this may reflect limited data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adequate first\u2010line supplementation with vitamin D and phosphate appeared to improve biochemical markers of MBD, but given the observational nature of this study, further longitudinal\/prospective studies are required to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.13813","type":"journal-article","created":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T09:03:11Z","timestamp":1514883791000},"page":"665-670","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Outcomes of standardised approach to metabolic bone disease of prematurity"],"prefix":"10.1111","volume":"54","author":[{"given":"Lit Kim","family":"Chin","sequence":"first","affiliation":[{"name":"Department of Paediatrics Dandenong Hospital, Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Doan","sequence":"additional","affiliation":[{"name":"Department of Neonatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne SL","family":"Teoh","sequence":"additional","affiliation":[{"name":"Department of Neonatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Neonatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Simm","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Centre for Hormone Research Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/902513"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853899608999080"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607113499590"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2007.00721.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-301025"},{"key":"e_1_2_8_7_1","first-page":"327","volume-title":"Clinical Nutrition","author":"Rodda C","year":"2013"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/08327823.2008.11688610"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2014.06.004"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004310051171"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e328345361b"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2014.03.001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1998.tb01525.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(02)00003-8"},{"key":"e_1_2_8_15_1","unstructured":"Department of Health and Human Services.Osteopenia of Prematurity. 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