Disorders of calcium, phosphorus, and magnesium metabolism in the neonate

Authors: ABRAMS, STEVEN - Children'S Nutrition Research Center (CNRC); TIOSANO, DOV - Rambam Health Care Campus

Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: 6/1/2014
Publication Date: 1/1/2015
Citation: Abrams, S.A., Tiosano, D. 2015. Disorders of calcium, phosphorus, and magnesium metabolism in the neonate. In: Martin, R.J., Fanaroff, A.A., Walsh, M.C., editors. Fanaroff & Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 10th edition. Philadelphia, PA: Elsevier Saunders. p. 1460-1489.

Interpretive Summary:

Technical Abstract: Approximately 98% of the calcium, 80% of the phosphorus, and 65% of the magnesium in the body are in the skeleton. These elements, often referred to as the "bone minerals" are also constituents of the intracellular and extracellular spaces. The metabolism of these bone minerals and mineralization of the skeleton are complex functions that require the interaction of various parameters. These include an adequate supply of nutrients, including proteins for collagen matrix synthesis, and an adequate intake and absorption of calcium and phosphorus for full bone mineralization. During prenatal development, nutrients are transferred mainly across the placenta. From the analysis of stillbirths and deceased neonates, it has been calculated that during the last trimester of gestation, the daily accretion per kilogram of body weight represents approximately 100 to 130 mg of calcium, 60 to 70 of phosphorus, and 0.75 g of magnesium. After birth, nutritient intake from most enteral sources, especially unfortified human milk, is below the amount needed to achieve this level of mineral retention.