Bone mineralisation in ex-preterm infants aged 8 years

Bowden, Lemuel; Jones, Chris; Ryan, Steven

doi:10.1007/s004310051171

Cited by 63 publications

(52 citation statements)

References 23 publications

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“…Unfortunately, bone mineralization is one of the major challenges of neonatal management in low (LBW) and very low birth weight (VLBW) infants, and osteopenia is recognized with increasing frequency (2 -4). Despite the likelihood of a spontaneous resolution of the osteopenia at the appendicular (5,6) as well as at the axial skeleton (7,8), several studies in former preterm infants have demonstrated persisting lower bone mineral content (BMC) (9,10), particularly at the hip (11).…”

Section: Introductionmentioning

confidence: 99%

Quantitative ultrasound for the assessment of osteopenia in preterm infants

Rubinacci¹,

Moro²,

Boehm³

et al. 2003

European Journal of Endocrinology

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Objective: To evaluate the potential role of quantitative ultrasound (QUS) investigation in assessing the osteopenia of prematurity. Design: QUS parameters measured at the time of discharge were related to the anthropometric characteristics and age (postnatal and gestational) of 51 (34 female and 17 male) preterm infants fed fortified human milk. Methods: QUS evaluation was performed at the humerus (h) by measuring two parameters: ultrasound velocity (hSOS, in m/s) and bone transmission time (hBTT, in ms). A group of 43 term infants (29 female and 14 male) was also evaluated. Results: In preterm infants, significant correlations were found for hSOS and hBTT vs gestational age (r ¼ 0.504, 0.477, P , 0.0001), length (r ¼ 0.641, 0.594, P , 0.0001) and weight (r ¼ 0.580, 0.562, P , 0.0001) at birth, and length (r ¼ 0.341, 0.332, P , 0.05) and weight (r ¼ 0.331, r ¼ 0.362, P , 0.05) at QUS measurement. In preterm infants, both QUS parameters were negatively correlated with age (r ¼ 2 0.536, P , 0.0001, r ¼ 2 0.443, P , 0.001) and were significantly lower than in the term infants (hSOS: 1664^42 m/s vs 1734^28 m/s, P , 0.0001; hBTT: 0.58^0.24 ms vs 1.06^0.15 ms, P , 0.0001) even when adjusted for body length (P , 0.05). In preterm infants, hSOS was also negatively correlated with postconceptional age (r ¼ 2 0.322, P , 0.05).Conclusions: This study suggests that bone mineral accrual is mainly determined by the development in utero, and that prematurity induces a halt in the bone development process in the early postnatal period. QUS parameters are correlated with the severity of prematurity and might therefore have clinical applications when bone maturation in early life needs to be determined.

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Section: Introductionmentioning

confidence: 99%

Quantitative ultrasound for the assessment of osteopenia in preterm infants

Rubinacci¹,

Moro²,

Boehm³

et al. 2003

European Journal of Endocrinology

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“…Prematurity, irrespective of birth weight, was found to be associated with lower BMD in infancy and early childhood (1,(6)(7)(8)(9). In contrast, other studies in young children could not show differences in BMD due to prematurity (2,10).…”

Section: Introductionmentioning

confidence: 75%

Preterm birth does not affect bone mineral density in young adults

Breukhoven

Leunissen²,

Kort³

et al. 2011

European Journal of Endocrinology

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Objective: Previous studies showed conflicting data on the effect of prematurity on bone mineral density (BMD) in infants and children. Only a few studies investigated the long-term effects of prematurity on BMD in early adulthood. The objective of our study was to assess the long-term effects of preterm birth on BMD of the total body (BMD TB ), lumbar spine (BMD LS ) and bone mineral apparent density of the LS (BMAD LS ). Design: Cross-sectional study. Methods: It consists of two hundred and seventy-six healthy subjects without serious postnatal complications, aged 18-24 years. The contribution of gestational age to the variance in BMD in young adulthood and the differences in BMD between 151 subjects born preterm (median gestational age 32.2 weeks (interquartile range (IQR) 30.3-34.0)) and 125 subjects born at term (median gestational age 40.0 weeks (IQR 39.0-40.0)) were investigated. BMD was determined by dual-energy X-ray absorptiometry. Results: There were no significant linear correlations between gestational age and BMD TB (rZ0.063, PZ0.30), BMD LS (rZ0.062, PZ0.31) and BMAD LS (rZ0.069, PZ0.26). Also after adjustment for possible confounders, gestational age was no significant contributor to the variance in BMD TB (PZ0.27), BMD LS (PZ0.91) and BMAD LS (PZ0.87). No significant differences were found between preterm and term subjects with regard to BMD TB , BMD LS and BMAD LS . Conclusion: In our cohort of 276 young adults, aged 18-24 years, gestational age was not a significant determinant in the variance of BMD. Preterm birth without serious postnatal complications is not associated with a lower BMD in young adulthood.

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“…Total body BMC and cortical area of the distal tibia have been reported to be lower in ex-preterm preschool children, even after adjusting for current body weight [19] . Lower bone mineral content and density has also been found in school age children born preterm [20,21] . Expreterm children have been shown to have increased urinary calcium excretion at age 8 years associated with a reduction in height and hip bone mineral density [22] .…”

Section: Osteopaenia Of Prematuritymentioning

confidence: 99%

“…Neonatal osteopathy might also adversely affect linear growth. Studies have shown that former preterm infants tend to be shorter and lighter than their term counterparts [16,17] and high neonatal alkaline phosphatase (ALP) has been significantly associated with short stature at 18 months and 10 years of age [17,18] . Total body BMC and cortical area of the distal tibia have been reported to be lower in ex-preterm preschool children, even after adjusting for current body weight [19] .…”

Section: Osteopaenia Of Prematuritymentioning

confidence: 99%

Quantitative Ultrasound Assessment of Bone Health in the Neonate

McDevitt

Ahmed²

2006

Neonatology

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For a number of reasons there is a need to explore reliable non-invasive methods for assessing bone health in neonates and young infants. Epidemiological studies suggest that early events in life may predispose the adult to degenerative diseases such as osteoporosis. Preterm infants have an increased risk of low bone mass because of limited bone mass accretion in utero and a greater need for bone nutrients. Despite improvements in neonatal care fractures still occur. The diagnosis of osteopaenia of prematurity remains difficult as there is no screening test which is both sensitive and specific. Biochemical indices are non-diagnostic, and plain X-rays in the absence of fractures are poor at diagnosing bone disease. Although dual energy X-ray absorptiometry is increasingly used to assess bone mineral status in newborn infants, the size and immobility of the scanner, the length of time to perform the scan and use of ionising radiation make it unsuitable for routine use in the setting of the fragile very low birth weight infant. Quantitative ultrasound (QUS) was first developed in 1984, as a non-ionising, portable and low cost method of assessing bone health. The measurements obtained from QUS are thought to be related not only to the mineral density of the bone but also to reflect parameters of bone quality and strength. Preliminary studies suggest that this technique may be a useful method of assessing changes in bone health in preterm infants, but the data need to be interpreted carefully. This review will concentrate on the methodology of QUS and the studies that have already been performed in neonates.

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Bone mineralisation in ex-preterm infants aged 8 years

Abstract: Ex preterm infants have significant reduction in bone mineral mass commensurate with their reduced growth and reduced bone mineral density in their hips.

Cited by 63 publications

References 23 publications

Quantitative ultrasound for the assessment of osteopenia in preterm infants

Quantitative ultrasound for the assessment of osteopenia in preterm infants

Preterm birth does not affect bone mineral density in young adults

Quantitative Ultrasound Assessment of Bone Health in the Neonate

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