The role of calcium and phosphorus metabolism in the pathogenesis of newborn cephalohematoma

Abstract

Background. A special type of complication in cephalohematomas is pathological cranial vault remodeling. It is possible to trace the dynamics of bone tissue changes in cephalohematomas based on measuring the indexes of calcium and phosphorus metabolism in the blood of newborns. Aim. To measure the serum concentration of calcium and phosphorus metabolism indexes in neonatal patients with cephalohematomas and to evaluate the dynamics of local bone changes in the projection of cephalohematoma. Methods. The study included 90 infants observed during the newborn period; 30 of them had medium and large cephalohematomas (punctured); 30 had small cephalohematomas (not punctured); and 30 healthy infants. The concentration of calcium and phosphorus metabolism indexes was measured photometrically with an Indiko analyzer using ThermoFisher Scientific Inc. kits. Ultrasonography and local craniometry were used to record local bone changes. Results. On days 10 and 28, the total calcium concentration in patients with medium and large cephalohematomas was 28.6‒31.5% lower than in the control group. The decrease in blood calcium in patients with medium- and large-volume cephalohematomas was not associated with a compensatory increase in parathyroid hormone and was evident in a more pronounced local osteolytic process in the projection of hemorrhage. Conclusion. Resolution of cephalohematomas is accompanied by local bone changes that depend on calcium metabolism. Changes in the parameters of calcium and phosphorus metabolism may reflect the dynamics of local pathological cranial bone remodeling during subperiosteal hemorrhage.