Metabolic Bone Disease in Preterm Neonates With Fetal Growth Restriction (FGR): A Prospective Cohort Study

Objectives To study the association of fetal growth restriction (FGR) with metabolic bone disease in preterm neonates. Methodology This prospective cohort study included 94 preterm neonates with FGR as cases and an equal number of gestation-matched appropriate for gestational age (AGA) neonates without FGR as controls. The incidence of metabolic bone disease, and serum biochemical markers at various time intervals till 6 months corrected age were compared. The risk factors for metabolic bone disease and its association with stunting at 6 months of corrected age were studied. Results The incidence of metabolic bone disease, though higher in the FGR neonates (15.5%), was not significantly different from AGA neonates (6.7%) [RR (95%CI) 0.92–5.82; P =0.06]. Birth weight [aOR (95%CI) 0.8 (0.64–0.98); P =0.03] and time to reach full feeds [aOR (95%CI) 1.17 (1.01–1.36); P =0.03] were significantly associated with an increased risk of metabolic bone disease after adjusting for FGR status. Mean (SD) levels of calcium, phosphorus, alkaline phosphatase, parathormone (PTH), and vitamin D were similar in both groups. No significant association existed between metabolic bone disease and stunting at 6 months of corrected age [RR (95%CI) 2 (0.75–5.4); P =0.16]. Conclusion FGR was not found to be significantly associated with metabolic bone disease in preterm neonates.