Vol. 7, Issue 2, Part B (2024)

Background: Due to their early delivery, preterm newborns lack bone mineralization in the third trimester, causing osteopenia of prematurity (OP). These final weeks are crucial because 80% of bone mineralization occurs and intrauterine development is fast. Study goals: to assess the effects of coffee on osteopenia of prematurity (OOP) utilizing serum alkaline phosphatase (serum-ALP) levels and radiographic findings in the 4th week of life.

Method: This prospective cohort study took place in the NICUs of three hospitals within Medical City, Baghdad, targeting neonates under 32 weeks of gestational age (GA) and a birth weight under 1500 grams. These infants, treated with caffeine for Apnea of Prematurity (AOP) until they were 28 days old, were analyzed to explore the relationship between serum alkaline phosphatase (ALP) levels and neonatal outcomes related to Osteopenia of Prematurity (OOP). Participants were categorized into high and low ALP groups, with data collected on demographics, clinical characteristics, feeding practices, and medication use. The study aimed to identify key factors influencing bone health in premature infants.

Results: The study highlights significant associations between caffeine-treated preterm infants with osteopenia and higher incidences of Respiratory Distress Syndrome (RDS), poor weight gain, and prolonged hospital stays. Increased levels of alkaline phosphatase (ALP), phosphorus, and calcium were observed in these infants, alongside a greater prevalence of grade I and II osteopenia on post-treatment X-rays. These findings emphasize the potential risks associated with caffeine therapy in the bone health of preterm infants.

Conclusion: The study reveals significant links between osteopenia in caffeine-treated preterm infants and clinical factors such as Respiratory Distress Syndrome (RDS), poor weight gain, prolonged hospital stays, and interventions like Total Parenteral Nutrition (TPN) and steroids. Elevated levels of alkaline phosphatase (ALP) and phosphorus suggest caffeine's influence on bone metabolism, underscoring the intricate relationship between neonatal medical treatments and bone health outcomes.