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Metabolic bone disease of prematurity-National survey of current neonatal and paediatric endocrine approaches.

Authors
  • Chinoy, Amish1, 2
  • Mughal, Mohammed Zulf1, 2
  • Padidela, Raja1, 2
  • 1 Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK.
  • 2 Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
Type
Published Article
Journal
Acta Paediatrica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Jun 01, 2021
Volume
110
Issue
6
Pages
1855–1862
Identifiers
DOI: 10.1111/apa.15654
PMID: 33145793
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study aimed to identify current trends in the management of metabolic bone disease of prematurity (MBDP) in the United Kingdom. A nationwide electronic survey was disseminated to all neonatal networks across the United Kingdom, as well as to paediatric endocrinologists for comparison. Weighted averages were used to compare relative importance placed on screening and diagnostic investigations (1 = not important, 5 = essential). Sixty-nine individuals responded from 53 neonatal units. Greatest emphasis was placed on levels of serum phosphate and alkaline phosphatase for screening (weighted average 4.5 and 4.6, respectively), diagnosis (weighted average 4.1 and 4.5, respectively) and monitoring (93% and 97% of neonatal responders, respectively) of MBDP by neonatologists. Although similar results were obtained for endocrinologists, significantly greater emphasis was placed on plasma parathyroid hormone (PTH) level for screening, diagnosis and monitoring (p < 0.001 for each). Phosphate supplementation was reported almost universally by neonatal responders (99%), but was significantly less for endocrine responders (62%) for the treatment of MBDP (p < 0.001). There is an under-utilisation of plasma PTH as a screening, diagnostic and monitoring investigation to guide appropriate supplementation for MBDP by neonatologists. © 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

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