Learn About Osteopenia
Osteopenia is a decrease in the amount of calcium and phosphorus in the bone. This can cause bones to be weak and brittle. It increases the risk for broken bones.
Neonatal rickets; Brittle bones - premature infants; Weak bones - premature infants; Osteopenia of prematurity
During the last 3 months of pregnancy, large amounts of calcium and phosphorus are transferred from the mother to the baby. This helps the baby grow.
A premature infant may not receive the proper amount of calcium and phosphorus needed to form strong bones. While in the womb, fetal activity increases during the last 3 months of pregnancy. This activity is thought to be important for bone development. Most very premature infants have limited physical activity. This may also contribute to weak bones.
Very premature babies lose much more phosphorus in their urine than do babies that are born full-term.
A lack of vitamin D may also lead to osteopenia in infants. Vitamin D helps the body absorb calcium from the intestines and kidneys. If babies do not receive or make enough vitamin D, calcium and phosphorous will not be properly absorbed. A liver problem called cholestasis may also cause problems with vitamin D levels.
Water pills (diuretics) or steroids can also cause low calcium levels.
Most premature infants born before 30 weeks have some degree of osteopenia, but will not have any physical symptoms.
Infants with severe osteopenia may have decreased movement or swelling of an arm or leg due to an unknown fracture.
Therapies that appear to improve bone strength in infants include:
- Calcium and phosphorus supplements, added to breast milk or IV fluids
- Special premature formulas (when breast milk is not available)
- Vitamin D supplementation for babies with liver problems
Midwest Center For Women's Healthcare
Karyn Grimm Herndon, MD, FACOG, has offices in Evanston and Glenview and is affiliated with NorthShore University HealthSystem (Evanston, Skokie and Glenbrook Hospitals). A Board Certified OB-GYN since 1994, Dr. Herndon is a Fellow of the American College of Obstetricians and Gynecologists. She attended the University of Florida's College of Medicine in Gainesville after completing her undergraduate studies at Brown University. Following her residency at Northwestern University Medical School, she stayed on the full-time faculty for several years. Dr. Herndon continues to teach and served as the Director of Resident Education for more than 10 years. She is honored to have been named one of Chicago's Best Doctors on several occasions. Dr. Herndon is rated as an Advanced provider by MediFind in the treatment of Osteopenia. Her top areas of expertise are Melorheostosis with Osteopoikilosis, Melorheostosis, Osteopenia, and Endometrial Polyps.
Amish Chinoy practices in Manchester, United Kingdom. Mr. Chinoy is rated as an Elite expert by MediFind in the treatment of Osteopenia. His top areas of expertise are Osteopenia, Hypophosphatemia, Familial Hypocalciuric Hypercalcemia Type 1, and Juvenile Primary Osteoporosis.
University Of Virginia Physicians Group
Joann Pinkerton is an Obstetrics and Gynecologist in Charlottesville, Virginia. Dr. Pinkerton is rated as a Distinguished provider by MediFind in the treatment of Osteopenia. Her top areas of expertise are Menopause, Postmenopausal Osteoporosis, Premature Ovarian Failure, Hormone Replacement Therapy (HRT), and Oophorectomy. Dr. Pinkerton is currently accepting new patients.
Fractures will most often heal well on their own with gentle handling and increased dietary intakes of calcium, phosphorus, and vitamin D. There may be an increased risk for fractures throughout the first year of life for very premature infants with this condition.
Studies have suggested that very low birth weight is a significant risk factor for osteoporosis later in adult life. It is yet unknown whether aggressive efforts to treat or prevent osteopenia of prematurity in the hospital after birth can decrease this risk.
Summary: Metabolic bone disease of prematurity (MBDP) is caused by insufficient content of calcium, phosphorus, and organic protein matrix in preterm infants or bone metabolism disorder, which is one of the complications affecting the quality of life of preterm infants. The early symptoms of MBDP are insidious, and there is no unified and clear diagnostic method. The diagnosis is mostly based on typical cl...
Published Date: November 06, 2023
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Abrams SA, Tiosano D. Disorders of calcium, phosphorus, and magnesium metabolism in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 87.
Eitel KB, Koves IH, Ness KD, Salehi P. Disorders of calcium and phosphorus metabolism. In: Gleason CA, Sawyer T, eds. Avery's Diseases of the Newborn. 11th ed. Philadelphia, PA: Elsevier; 2024:chap 83.