Neonatal hypocalcemia
Neonatal hypocalcemia is an abnormal clinical and laboratory hypocalcemia condition that is frequently observed in infants.[1]
Healthy term infants go through a physiological nadir of serum calcium levels at 7.5 - 8.5 mg/dL by day 2 of life. Hypocalcemia is a low blood calcium level. A total serum calcium of less than 8 mg/dL (2mmol/L) or ionized calcium less than 1.2 mmol/L in term neonates is defined as hypocalcemia. In preterm infants, it is defined as less than 7mg/dL (1.75 mmol/L) total serum calcium or less than 4mg/dL (1 mmol/L) ionized calcium. [2]
Both early onset hypocalcemia (presents within 72h of birth) and late onset hypocalcemia (presents in 3-7 days after birth) require calcium supplementation treatment.
Risk factors of early neonatal hypocalcemia
- Prematurity
- Perinatal asphyxia
- Diabetes mellitus in the mother
- Maternal hyperparathyroidism
- Intrauterine growth retardation (IUGR)
- Iatrogenic
Risk factors of late neonatal hypocalcemia
- Exogenous phosphate load
- Use of gentamicin
- Gender and ethnic: late neonatal hypocalcemia occurred more often in male infants and Hispanic infants
- Others
- Magnesium deficiency
- Transient hypoparathyroidism of newborn
- Hypoparathyroidism due to other causes (DiGeorge Syndrome)
References
- Jain, A., Agarwal, R., Sankar, M. J., Deorari, A., & Paul, V. K. (2010). Hypocalcemia in the newborn. Indian Journal of Pediatrics, 77, 1123-1128.
- Oden, J., Bourgeois, M. (2000). Neonatal endocrinology. Indian Journal of Pediatrics, 77, 217-213.