The authors investigated the bone density and parameters of bone metabolism in 25 premature neonates with a birth weight lower than 1500 g. The objective of investigation and care is to prevent the development of bone changes which are caused mainly by a reduced supply of phosphorus and to a lesser extent of calcium and vitamin D. Human milk contains significantly less phosphorus and calcium as compared with the foetoplacentar circulation. Therefore in premature deliveries the period when higher mineral supplies are provided is markedly reduced, this period being essential for the proper development of the neonatal skeleton. The authors recorded serum values of calcium, phosphorus, parathormone, ALP, osteocalcin and procollagen I; in urine the output of Ca, P and crosslinks. Densitometric examination revealed in all premature neonates at the age of the foreseen time of delivery osteopenia or osteoporosis. During a check-up examination made after a 3 - 8-month interval after the first examination when supplementation with calcium, phosphorus and vitamin D was made an increase of the bone mineral to 193 % according to bone mineral density (BMD) was found and 200 - 350 % according to the total mineral content expressed as bone mineral content (BMC). This observation and a decline of markers of bone resorption provides evidence of the importance of supple- mentation not only from the aspect of prevention of metabolic osteopathies, but also for optimal growth and achievement of the peak bone mass comparable with the healthy full-term population.

        Key words: primary osteoporosis prevention, preterm newborns, supplementation, bone mineral content, dualphoton densitometry, accuracy and precision