Role of Serum Alkaline Phosphatase in Osteopenia of Premature Infants

Overview & Synopsis

Background: Osteopenia, a condition indicative of reduced bone mineral content, is commonly observed among premature neonates. Early detection is crucial to initiate timely interventions and reduce the risk of long-term skeletal complications. Identifying reliable biochemical markers may enhance prediction and management strategies. Aim of the Study: The aim of this study was to assess whether serum alkaline phosphatase (ALP) levels can be used to predict osteopenia in premature infants. Patients and Methods: An observational cross-sectional study was conducted at the Neonatal Intensive Care Units of Baghdad Teaching Hospital and Children Welfare Teaching Hospital in Baghdad, Iraq. The study spanned six months, from October 1, 2024, to March 31, 2025. A total of 100 premature infants were enrolled. Osteopenia diagnosis was made by a senior pediatrician based on radiographic findings and supporting investigations. Serum ALP levels were measured twice during hospitalization. Results: Osteopenia was identified in 17% (17/100) of the premature infants. Infants diagnosed with osteopenia had significantly shorter gestational age and lower birth weight compared to those without the condition. Additionally, ALP levels in both the first and second samples were significantly elevated among osteopenic infants. Other associated factors included premature rupture of membranes and low Apgar scores at both one and five minutes after birth. Conclusions: Elevated serum alkaline phosphatase levels serve as a significant biochemical marker for predicting osteopenia in premature neonates. This marker may aid clinicians in early identification and management of at-risk infants.