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CAUSES OF DEFECTIVE SKELETAL MINERALISATION IN LOW BIRTHWEIGHT INFANTS

The ideal postnatal growth of the low birthweight infant should, quantitatively and qualitatively resemble the growth that would have occurred had he remained in utero. Using published data from the chemical analyses of foetal bodies it can be shown that between 24 and 36 weeks gestation calcium accumulates in the foetal body in an exponential menner, and it can be calculated that calcium accumulates at a rate of 120 150 mg per kilogram and day. Using metabolic balance techniques twelve low birthweight infants (29-33 weeks gestation) have been studied continuously for periods of 20-60 days. By comparing the measured calcium retentions with the calculated rate of accumulation in utero it can be shown that low birthweight infants accumulate a gross body deficit of calcium, retaining about 1/3-1/5 of the amount of calcium they would have retained had they remained in utero. Simultaneous fat balances have been performed which confirm the gross malabsorption of fat. The role of fat malabsorption on calcium absorption will be discussed.