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J Clin Transl Endocrinol. 2014 Jul 4;1(3):85-91. doi: 10.1016/j.jcte.2014.06.004. eCollection 2014 Sep.

Metabolic bone disease of prematurity.

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Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, 295 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA 19104, USA.
Division of Neonatology, The Children's Hospital of Philadelphia-Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107, USA.


Metabolic bone disease (MBD) of prematurity remains a significant problem for preterm, chronically ill neonates. The definition and recommendations for screening and treatment of MBD vary in the literature. A recent American Academy of Pediatrics Consensus Statement may help close the gap in institutional variation, but evidence based practice guidelines remain obscure due to lack of normative data and clinical trials for preterm infants. This review highlights mineral homeostasis physiology, current recommendations in screening and monitoring, prevention and treatment strategies, and an added perspective of a bone health team serving a high volume referral neonatal intensive care center.


ALP, Alkaline phosphatase; ELBW, Extremely low birth weight; MBD, Metabolic bone disease; Metabolic bone disease; Osteopenia; PTH, Parathyroid hormone; Prematurity; Rickets; TRP, Tubular reabsorption of phosphate; VLBW, Very low birth weight

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