The effect of perinatal exposure to intravenous aluminum on the neurologic development of 227 premature infants (<34 weeks gestation, <1850g weight) from the neonatal intensive care unit of Rosie Maternity Hospital, Cambridge, UK was studied at the Dunn Nutrition Unit, Cambridge, and the Institute of Child Health, London. The 90 infants who received standard IV feeding solutions, containing 25 mcg Al/dl, had a lower Bayley Mental Development Index at 18 months than the 92 infants who received aluminum-depleted solutions (2.2 mcg Al/dl). Aluminum exposure (45 mcg/kg/day) caused a mean loss on the Bayley Index of 1 point per day. Infants receiving standard IV solutions for 10 or more days had a 10 point deficit in their Mental Development Index and were twice as likely to have an index below 85. [1]

COMMENT. Aluminum exposure from standard intravenous solutions in preterm infants may cause neurotoxicity and developmental delay at 18 months. The majority of cases of aluminum poisoning occur as dialysis encephalopathy in adult patients on hemodialysis and peritoneal dialysis. Tap water, especially when treated with aluminum sulfate to remove organic contaminants, contains high concentrations of aluminum and is a frequent cause of dementia following repeated dialyses. Memory loss, malaise, and speech disturbance are followed by myoclonus, somnolence, and dementia. The EEG shows bursts of delta activity and high voltage, symmetric spikes. [2]