Parathyroid hormone in neonates

Aim: The goal of this study is to describe secondary hyperparathyroidism in extremely low birthweight (ELBW) neonates and their response to enteral calcium carbonate (CaCO₃) supplementation. Methods: A retrospective case series was conducted on extremely low birth infants, <1000 g birthweight, who survived hospitalisation, had no major congenital anomalies and had all their care in our institution Results During this 6-year period, 231 ELBW infants survived hospitalisation at our institution. Of the 231 patients, parathyroid hormone (PTH) levels were performed in 66 of these patients (29%) and were elevated in 54 patients (82% of those tested). The timing of this testing was sporadic and was often performed after recognising osteopenia on radiography. Of the 54 patients with high PTH levels, 44 (81%) were treated with CaCO ₃ and PTH levels were monitored while on therapy. The average duration of therapy was 41 ± 28 days, with 64% of PTH levels returning to normal before discharge. Conclusions: PTH is a major hormone responsible for bone resorption, and serum levels may be a useful marker in identifying ELBW neonates at risk for metabolic bone disease. ELBW neonates with secondary hyperparathyroidism may benefit from enteral supplementation with CaCO ₃. Further studies are needed to better evaluate the incidence, timing and potential treatment of hyperparathyroidism in ELBW infants.