HYPOCALCEMIA AMONG PRETERM AND VERY LOW BIRTH WEIGHT NEONATES IN A TRTIARY CARE NEOATAL UNIT
Keywords:Hypocalcemia, Ionized calcium, Premature neonates, Very low birth weight
Objective: To assess the relationship of hypocalcemia with prematurity and low birth weight.
Study Design: Prospective observational study
Place and Duration of Study: Study was conducted in Pak Emirates Military Hospital Pakistan, from Jan 2018 to Jun 2018.
Methodology: Seventy five preterm and very low birth weight neonates were selected for this study. The cut-off values for hypocalcemia were taken as Ionized Calcium level <1mmol/land total Calcium level of <1.75mmol/l. The study samples were drawn between 24-72 hrs of life. All babies received prophylactic intravenous calcium gluconate by 4ml/kg/day.
Results: The frequency of hypocalcemia was found to be 50.7% in premature and very low birth weight neonates with 37.3% in early preterm neonates and 13.3% in late preterm. The average ionized calcium levels in hypocalcemic neonates were found to be 0.844 ± 0.014mmol/L and that in normocalcemic neonates were 1.105 ± 0.017mmol/L. A statistically significant incidence of hypocalcemia was documented in premature and very low birth weight neonates with a p-value <0.001. However, no definite linearity was established between hypocalcemia and gestational age or birth weight.
Conclusion: Hypocalcemia has an increased frequency in early preterm neonates within 72 hours due to immature hormonal responses and poor calcium reserves. However, a significant direct proportionate relationship between prematurity and low birth weight with early onset neonatal hypocalcemia could not be established through our study.