Incidence and Risk factors for Osteopenia of Prematurity in infants less than 32 weeks in Sulaimani Maternity Teaching Hospital

Document Type : Research Paper

Authors

1 Pediatric Neonatology, Department of Clinical Sciences, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.

2 Branch of Clinical Sciences, College of Medicine, University of Sulaimani, Sulaymaniyah City, Kurdistan Region, Iraq.

10.22038/psj.2026.93837.1518

Abstract

Background:
This study aimed to determine the incidence and identify risk factors for osteopenia of prematurity in preterm infants born before 32 weeks of gestation.
 
methods:
This was a prospective cohort design in infants born before 32 weeks of gestation at Sulaimani Obstetrics and Gynecology Teaching Hospital in Iraq. All infants enrolled in the study were followed longitudinally. The target population included all preterm infants born at less than 32 weeks of gestational age, or weighing <1500g, and admitted to the Neonatal Intensive Care Unit (NICU) of the hospital. Maternal age, parity, pregnancy complications, antenatal steroid use, mod of delivery, Infant factors: gestational age, birth weight, Apgar score, respiratory support (need for mechanical ventilation, medications, and nutritional intake were measured. A p-value<0.05 was considered statistically significant.
 
Results:
The overall prevalence of OOP was 21.8%. Infants with OOP had significantly lower gestational age and birth weight (P≤0.001). Prolonged TPN duration (14.58±10.20 vs. 4.47±6.42 days; P≤0.006), delayed enteral feeding initiation (22.50±10.96 vs. 11.42±6.12 days; P≤0.005), and later supplementation (22.75±10.28 vs. 11.21±5.66 days; P≤0.005) were strongly associated with OOP. Higher rates of blood transfusion (83.3% vs. 31%; P≤0.005). Linear regression confirmed that lower gestational age (β=–0.553, P≤0.002), lower birth weight (β=–0.465, P≤0.001), and delayed enteral feeding (β=–0.534, P≤0.001) were significant independent predictors of OOP.
 
Conclusions:
OOP is prevalent in this cohort and is strongly linked to prematurity severity and postnatal nutritional practices. Early enteral feeding, minimizing prolonged Total parenteral nutrition, and vigilant biochemical monitoring (serum phosphorus and alkaline phosphatase) are critical preventive strategies. 

Keywords

Main Subjects

References

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Journal of Patient Safety & Quality Improvement
Volume 14, Issue 3
July 2026
Pages 169-181

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