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Bone mineralisation in ex-preterm infants aged 8 years
L S Bowden1, C J Jones, S W Ryan
1Neonatal Unit, Liverpool Women's Hospital, UK.
Insights
Ex preterm infants show reduced bone mineral mass and hip bone density at age 8. While bone mineral content adjusted for size was similar, hip bone mineral density remained lower, indicating long-term skeletal deficits.
Area of Science:
- Pediatric Bone Health
- Neonatal Medicine
- Skeletal Development
Background:
- Perinatal mineral deficits are common in preterm infants.
- Limited data exists on long-term bone mineralization in this population.
- Understanding skeletal outcomes is crucial for preterm infant follow-up.
Purpose of the Study:
- To assess long-term bone mineral content (BMC) and bone mineral density (BMD).
- To compare skeletal outcomes in ex-preterm infants (<32 weeks gestation) with controls at 8 years of age.
- To identify factors associated with bone mineralization deficits.
Main Methods:
- Dual-energy X-ray absorptiometry (Hologic QDR 1000) used to measure BMC and BMD.
- Measurements taken at lumbar spine, forearm, and hip in 46 ex-preterm infants and controls.
- Height, weight, and fracture history were recorded.
Main Results:
- Ex-preterm infants were shorter and lighter than controls.
- Unadjusted BMC was lower in preterm infants, but normalized for height and weight.
- BMD was significantly reduced in the hip of the preterm group.
- Prolonged ventilation correlated with lower BMC; preterm formula feeding duration correlated with higher BMC.
- Accidental fractures were less common in ex-preterm infants.
Conclusions:
- Ex-preterm infants exhibit reduced bone mineral mass relative to their growth.
- Significant reduction in hip bone mineral density persists at 8 years of age.
- Long-term skeletal monitoring is important for individuals born preterm.
Unlabelled:
In preterm infants, in whom perinatal mineralisation deficits are common, there is little information on long-term bone mineralisation. Using a Hologic QDR 1000 dual energy X-ray absorptiometer, bone mineral content and density (BMC and BMD) were measured in lumbar, spine, forearm and hip in 46 ex- preterm infants <32 weeks gestation together with controls at 8 years of age. Height and weight were recorded, as was history of bone fracture. Preterm infants were shorter by 4.9 cm (95% CI, 2.4 7.3) and lighter by 2.6 kg (95% CI, 0.7 4.4). BMC for all sites measured was significantly lower in the preterm group, but did not remain so when adjusted for height and weight. BMD was significantly reduced in the hip of the preterm group. Prolonged ventilation was associated with the lowest BMC and duration of preterm formula feeding correlated with higher BMC. Accidental fractures were less common in the preterm group.
Conclusion:
Ex preterm infants have significant reduction in bone mineral mass commensurate with their reduced growth and reduced bone mineral density in their hips.