Hypocalcemia is a common metabolic disorder in newborns characterized by low serum calcium levels. Symptoms include seizures, cardiac issues, and poor feeding, and the condition can manifest as early- or late-onset, developing 72 hours before or after birth, respectively. Early-onset hypocalcemia is normally asymptomatic, and there is no consensus on the most appropriate treatment strategy for asymptomatic patients.
In a review published in the International Journal of Pediatrics, Dogus Vuralli of Hacettepe University in Turkey provides an overview of the causes, diagnosis, and treatment of hypocalcemia. The author discusses the varied roles of calcium in the body, and defines hypocalcemia as total serum calcium levels of <8 mg/dL for infants weighing >1500 g.
The review provides valuable insights into the need to monitor serum calcium levels in infants at high risk of early-onset hypocalcemia, given the asymptomatic nature of the condition. This includes preterm infants, those with severe perinatal asphyxia, and in cases of maternal gestational diabetes.
The author details the most appropriate treatment strategies, which center around calcium replacement. They recommend that infants with low serum calcium should be treated immediately while investigations into the cause are ongoing. A dose of 40–80 mg/kg/d elemental calcium is proposed for asymptomatic newborns alongside frequent evaluation to avoid complications.
This blog post is distributed under the Creative Commons Attribution License (CC-BY). Illustration by David Jury.