Neonatal hypocalcemia is an abnormal clinical and laboratory hypocalcemia condition that is frequently observed in infants. It is commonly presented within the first 72 hours of a newborn's life.[1] Neonatal hypocalcemia can cause seizures in infants requiring a calcium infusion until homeostasis is achieved; allowing for positive clinical outcomes within weeks of treatment.[2][3][4][5]
Healthy term infants go through a physiological nadir of serum calcium levels at 7.5 - 8.5 mg/dL by day 2 of life. Hypocalcemia is a low blood calcium level. A total serum calcium of less than 8 mg/dL (2mmol/L) or ionized calcium less than 1.2 mmol/L in term neonates is defined as hypocalcemia. In preterm infants, it is defined as less than 7mg/dL (1.75 mmol/L) total serum calcium or less than 4mg/dL (1 mmol/L) ionized calcium.
Both early onset hypocalcemia (presents within 72h of birth) and late onset hypocalcemia (presents in 3-7 days after birth) require calcium supplementation treatment.
Infants with intrauterine growth retardation, perinatal asphyxia, preterm, and diabetic mothers are most likely to develop neonatal hypocalcemia.[1] It is not understood why premature infants have hypocalcemia, but a proposed idea is that a large increase of calcitonin may lead to hypocalcemia. Another hypothesis includes impaired secretion of parathyroid hormone.[6]
^Schafer, Anne L.; Shoback, Dolores (2013-07-19), "Hypocalcemia: Definition, Etiology, Pathogenesis, Diagnosis, and Management", Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Ames, USA: John Wiley & Sons, Inc., pp. 572–578, doi:10.1002/9781118453926.ch71, ISBN978-1-118-45392-6
