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新生儿骨骼健康的管理

Author
Steven A Abrams, MD
Section Editors
Joseph A Garcia-Prats, MD
Kathleen J Motil, MD, PhD
Deputy Editor
Alison G Hoppin, MD
Translators
周伟, 主任医师

引言

骨骼健康对新生儿来说是一个至关重要的问题，特别是对于存在佝偻病风险的早产儿。由于新生儿快速生长，与年龄较大的个体相比，所有新生儿对钙(Ca)和磷(P)的相对需求较高，钙和磷是骨结构完整性和骨骼生长的关键成分。早产儿有甚至更大的膳食需求，因为他们需要弥补晚期妊娠期间损失的这些营养素累积。

新生儿(包括早产儿)骨骼健康的管理将总结在此。

背景

在这一活跃的生长期，新生儿骨骼健康非常关键。因此，使婴儿获得关键营养素钙和磷的必需摄入量以确保充分的矿化来维持骨结构的完整性和骨骼生长是必要的。这些营养素的每日需求量受到婴儿的胎龄及影响肠道吸收和尿排泄的因素的影响。

胎龄和胎盘转运 — 在妊娠期间，钙和磷从母体主动转运至胎儿，在妊娠32-36周时达到累积率峰值：钙100-130mg/(kg·d)，磷60-70mg/(kg·d)，其中千克是指胎儿体重[1-4]。晚期妊娠是胎儿生长最为活跃的时期，并且为了应对胎儿对骨骼发育的较高需求，累积率增加。因此，胎龄越小，钙和磷的需求越大，以弥补损失的这些矿物质累积。

特别是超低出生体重儿(extremely low birth weight, ELBW，即出生体重小于1000g)或者是胎龄小于27周的早产儿，发生佝偻病的风险高[3,5,6]。未强化的母乳、胃肠外营养和为足月儿设计的配方食品，其钙和磷的含量都不足以完全满足早产儿骨骼矿化的需求。因此，使用这些喂养方式而不进一步补充将会限制骨骼生长，导致佝偻病发生，并且可能增加骨折的风险。 (参见下文‘早产儿的佝偻病’)

                          

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Literature review current through: 2017-06 . | This topic last updated: 2015-11-23.
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