Prevalence of Hypocalcaemia in Term Neonates and the Clinical Characteristics of the Affected Neonates Admitted to the Neonatal Intensive Care Unit at the University Teaching Hospital in Lusaka, Zambia
Keywords:
early neonatal hypocalcaemia, convulsions, term neonates, calcium, calcium gluconate
Abstract
The burden of neonatal hypocalcaemia remains unknown in Zambia. Convulsions with concurrent hypocalcaemia are a common complication seen in very ill neonates at The University Teaching Hospital (UTH) Neonatal Intensive Care Unit (NICU), now known as Women and Newborn Hospital. The unit admits close to 4000 neonates per year with various neonatal conditions. Meanwhile, studies around the globe have shown prevalence levels of neonatal hypocalcaemia ranging from 17% to 39%.This study endeavored to determine the prevalence of hypocalcaemia in term neonates, the clinical characteristics of the affected neonates and to establish the proportion of neonates with seizures who also had hypocalcaemia. This was a cross sectional study with a sample size of 174 neonates enrolled into the study by simple random sampling methods out of 240 screened neonates. Data were analyzed using SPSS version 2. The relationship between study variables and the outcome variable of interest (hypocalcaemia) was examined using logistic regression model. The prevalence of neonatal hypocalcaemia was found to be 26.4% (46/174) and 50% (23/46) of hypocalcaemic neonates presented with abnormal neurological features such as convulsions, hypertonia and hypotonia. Of the neonates who presented with convulsions in this study, 26.8% (19/71) were also found to have hypocalcaemia. However, there was no statistically significant association between convulsions and hypocalcaemia. The prevalence of hypocalcemia in term neonates admitted to NICU at UTH is high with half of the hypocalcaemic neonates manifesting neurological signs.References
1. Wandrup J, Kroner J, Pryds O, Kastrup KW. Age-related reference values for ionized calcium in the first week of life in premature and full-term neonates. Scand Journal Clinical Laboratory Investigations, 1988; 48:255.
2. Wandrup J. Critical Analytical and Clinical Aspects of Ionized Calcium in Neonates. Clinical Chemistry, 1989; 35/10, 2027-2033.
3. Loughead JL, Mimouni F, Tsang RC. Serum ionized calcium concentrations in normal neonates. American Journal Diseases of Childhood, 1988; 142:516.
4. Husain SM, Veligati N, Sims DG, et al. Measurement of ionized calcium concentration in neonates. Archives of Diseases of Childhood, 1993; 69:77.
5. Tsang R, Steichen J.J, Chan G.M. Neonatal Hypocalcaemia; Mechanism of Occurrence and Management. Critical care medicine, 1977; 5; 1; 56-61.
6. Tsang R.C, William O. Neonatal Hypocalcaemia in Low Birth Weight Infants. Paediatrics, 1970; 45; 773.
7. Tsang RC, Chen IW, Friedman MA, Chen I. Neonatal parathyroid function: role of gestational age and postnatal age. J Pediatr 1973;83:728-38.
8. Jain A, Agarwal R, Sankar M. J, Deorari A. K, Vinod K. P. Hypocalcaemia in the Newborn. Indian Journal of Paediatrics, 2008;75 (2): 165-169.
9. Zhou P, Markowitz M. Hypocalcemia in Infants and Children.Pediatrics in Review 2009; 30; 190.
10. Roberton N.R.C, Smith M.A. Early Neonatal Hypocalcaemia. Archives of disease in childhood.1975; 50: 604 – 609.
11. Medical Records, Department of Paediatric and Child Health, University Teaching Hospital, 2013 – 2015.
12. WHO, 2011. Guidelines on neonatal seizures. ISBN 978 92 4 154830 4.
13. Cho W, Yu HW, Chung HR, Yang SW, Choi CW, Kim BI. Clinical and Laboratory Characteristics of neonatal hypocalcaemia. Ann Pediatr Endocrinol Metab. Journal, 2015;20(2):86 – 91.
14. Sankar JM, Agarwal R, Deorari A, Paul VK. Management of Neonatal Seizures. Indian J Pediatr 2010;77:1129-35.
15. Cruikshank DP, Pitkin RM, Reynolds WA, Williams GA, Hargis GK. Effects of Magnesium Sulphate Treatment on Perinatal Calcium Metabolism. 1. Maternal and Fetal Responses. Am J Obstet Gynecol, 1979 Jun 1;134(3):243-9.
16. Bergman L, Kjellmer I, Selstam U. Calcitonin and Parathyroid Hormone – Relation to Early Neonatal Hypocalcaemia in Infants of Diabetic Mothers. Biol Neonate 1974;24:151-160.
17. Kovacs CS, Vitamin D in Pregnancy and Lactation: maternal, fetal, and neonatal outcomes from human and animal studies. The American Journal of Clinical Nutrition,2008;88 (suppl):520S-8S.
18. Shuman R, O’Gorman CS, Sochett EB. Case 1: Neonate with Seizures and Hypocalcaemia. Paediatric Child Health, 2008;13(3): 197 – 200.
2. Wandrup J. Critical Analytical and Clinical Aspects of Ionized Calcium in Neonates. Clinical Chemistry, 1989; 35/10, 2027-2033.
3. Loughead JL, Mimouni F, Tsang RC. Serum ionized calcium concentrations in normal neonates. American Journal Diseases of Childhood, 1988; 142:516.
4. Husain SM, Veligati N, Sims DG, et al. Measurement of ionized calcium concentration in neonates. Archives of Diseases of Childhood, 1993; 69:77.
5. Tsang R, Steichen J.J, Chan G.M. Neonatal Hypocalcaemia; Mechanism of Occurrence and Management. Critical care medicine, 1977; 5; 1; 56-61.
6. Tsang R.C, William O. Neonatal Hypocalcaemia in Low Birth Weight Infants. Paediatrics, 1970; 45; 773.
7. Tsang RC, Chen IW, Friedman MA, Chen I. Neonatal parathyroid function: role of gestational age and postnatal age. J Pediatr 1973;83:728-38.
8. Jain A, Agarwal R, Sankar M. J, Deorari A. K, Vinod K. P. Hypocalcaemia in the Newborn. Indian Journal of Paediatrics, 2008;75 (2): 165-169.
9. Zhou P, Markowitz M. Hypocalcemia in Infants and Children.Pediatrics in Review 2009; 30; 190.
10. Roberton N.R.C, Smith M.A. Early Neonatal Hypocalcaemia. Archives of disease in childhood.1975; 50: 604 – 609.
11. Medical Records, Department of Paediatric and Child Health, University Teaching Hospital, 2013 – 2015.
12. WHO, 2011. Guidelines on neonatal seizures. ISBN 978 92 4 154830 4.
13. Cho W, Yu HW, Chung HR, Yang SW, Choi CW, Kim BI. Clinical and Laboratory Characteristics of neonatal hypocalcaemia. Ann Pediatr Endocrinol Metab. Journal, 2015;20(2):86 – 91.
14. Sankar JM, Agarwal R, Deorari A, Paul VK. Management of Neonatal Seizures. Indian J Pediatr 2010;77:1129-35.
15. Cruikshank DP, Pitkin RM, Reynolds WA, Williams GA, Hargis GK. Effects of Magnesium Sulphate Treatment on Perinatal Calcium Metabolism. 1. Maternal and Fetal Responses. Am J Obstet Gynecol, 1979 Jun 1;134(3):243-9.
16. Bergman L, Kjellmer I, Selstam U. Calcitonin and Parathyroid Hormone – Relation to Early Neonatal Hypocalcaemia in Infants of Diabetic Mothers. Biol Neonate 1974;24:151-160.
17. Kovacs CS, Vitamin D in Pregnancy and Lactation: maternal, fetal, and neonatal outcomes from human and animal studies. The American Journal of Clinical Nutrition,2008;88 (suppl):520S-8S.
18. Shuman R, O’Gorman CS, Sochett EB. Case 1: Neonate with Seizures and Hypocalcaemia. Paediatric Child Health, 2008;13(3): 197 – 200.
Published
2020-03-31
How to Cite
1.
Zyambo K, Sinyangwe S, Chabala C. Prevalence of Hypocalcaemia in Term Neonates and the Clinical Characteristics of the Affected Neonates Admitted to the Neonatal Intensive Care Unit at the University Teaching Hospital in Lusaka, Zambia. Journal of Agricultural and Biomedical Sciences [Internet]. 31Mar.2020 [cited 21Nov.2024];4(1):1-. Available from: https://naturalsciences.unza.zm/index.php/JABS/article/view/349
Section
Biomedical Sciences
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