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Title: Assessment of mineralised bone mass and mineral supplementation in the newborn infant
Author: Harrison, Adele
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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This work consists of original research in aspects of fetal and neonatal bone mineralisation, as measured by a unique portable single photon absorptiometer. The scanner enables measurement of mineralisation in the first days of life in sick, ventilated infants, providing an opportunity to distinguish between antenatal and postnatal factors which may influence bone mineralisation. Aims: 1. To explore the relationship between bone mineralisation at birth and potential fetal mechanisms implicated in the control of materno-fetal calcium transport; 2. To examine the effect of individualised calcium and phosphorus supplementation on bone growth and mineralisation in preterm infants. Mineralisation was shown to be linearly related to birthweight from 23 to 41 weeks gestation. The relationship between birthweight and bone mineralisation was not improved by the addition of maternal factors in regression analysis. The hypothesis that a personalised mineral supplementation regimen based on routine plasma and urine calcium and phosphorus concentrations promotes bone mineralisation in the preterm infant and tested in a randomised controlled trial. Despite increased phosphorus supplementation in the trial infants, individualised mineral supplementation failed to enhance radial bone mineralisation. All infants remained significantly undermineralised at discharge home compared to weight-adjusted values. Mineral supplementation alone may not be sufficient to prevent significant demineralisation in the preterm population. This data supports the hypothesis that the change from the in utero to ex utero environment may have a more profound influence than the cessation of transfer of minerals from mother to infant, with other factors playing a role in the control of bone mineralisation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available