Factors Associated with Metabolic Bone Disease of Prematurity at Vietnam National Children’s Hospital

Abstract

Abstract: Objective: To determine factors associated with metabolic bone disease of prematurity (MBDP) in preterm infants born before 32 weeks of gestation. Methods: A cross-sectional study was conducted in 118 preterm infants with a gestational age < 32 weeks treated at the Neonatal Center of Vietnam National Children’s Hospital from June 2025 to February 2026. MBDP was defined as serum alkaline phosphatase > 600 IU/L combined with serum phosphate < 1.8 mmol/L. Factors associated with MBDP were analyzed using univariable and multivariable logistic regression. Results: MBDP was identified in 41 of 118 infants (34.7%; 95% CI: 26.8-43.7). Univariable analysis identified associations with lower birth weight, major neonatal morbidities, postnatal corticosteroid and diuretic exposure, blood-product transfusion, and prolonged parenteral nutrition. In multivariable analysis, parenteral nutrition beyond 14 days was the only factor that remained independently associated with MBDP (aOR = 2.86; 95% CI: 1.05-7.74; p = 0.039), whereas postnatal corticosteroid use showed borderline statistical significance (aOR = 2.92; 95% CI: 1.00-8.54; p = 0.050). Conclusion: Parenteral nutrition beyond 14 days was independently associated with MBDP. Preterm infants requiring prolonged parenteral nutrition should therefore be prioritized for monitoring of bone metabolism and optimization of nutritional strategies.

Keywords: Metabolic bone disease; prematurity; parenteral nutrition; alkaline phosphatase.

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