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Updated: Oct 3, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Lower femoral neck bone mineral density in prepubertal former preterm girls
S A Zamora1, D C Belli, R Rizzoli
1Gastroenterology Unit, Department of Paediatrics, University Hospital, Geneva, Switzerland. samuel.zamora@hcuge.ch
Insights
Former preterm girls aged 7-9 years had lower bone mineral density at the hip and radial metaphysis compared to term-born peers. Despite higher calcium intake, these bone deficits persisted, indicating long-term skeletal health implications for preterm birth.
Area of Science:
- Pediatrics
- Bone Health
- Perinatal Medicine
Background:
- Preterm birth can impact long-term skeletal development.
- Bone mineral density (BMD) is crucial for skeletal health.
- Understanding skeletal outcomes in former preterm children is important for early intervention.
Purpose of the Study:
- To assess bone mineral content and areal bone mineral density (aBMD) in former preterm girls aged 7-9 years.
- To compare skeletal parameters between former preterm girls and age-matched term controls.
- To investigate the relationship between calcium intake and aBMD in this cohort.
Main Methods:
- Case-control study design.
- Dual-energy X-ray absorptiometry (DXA) used to measure aBMD at six skeletal sites.
- Anthropometric measurements and calcium intake assessment via food-frequency questionnaire.
- Longitudinal follow-up of a subgroup for 1 year.
Main Results:
- Former preterm girls were lighter than controls but had higher calcium intake.
- Lower aBMD was observed in former preterms at the radial metaphysis, femoral neck, and total hip.
- aBMD at the radial and femoral diaphysis (cortical bone sites) was similar between groups.
- Lower femoral neck aBMD persisted in preterm girls after 1 year of follow-up.
Conclusions:
- Prepubertal former preterm girls exhibit catch-up growth but have reduced aBMD at specific skeletal sites.
- Lower aBMD at the hip and radial metaphysis suggests lasting skeletal deficits despite adequate calcium intake.
- Cortical bone sites may be less affected or more responsive to calcium intake in former preterm children.
Abstract:
The purpose of this case-control study was to determine bone mineral content and areal bone mineral density at various skeletal sites in former preterm girls, aged 7-9 years, and to compare these data with age-matched term controls. Subjects included 25 white, prepubertal, former preterm girls (gestational age 30.8 +/- 0.3 weeks, birthweight 1461 +/- 56 g [mean +/- SEM]). Controls included 50 healthy, white, prepubertal girls born at term and matched for age (two controls per case). Measurements included anthropometric variables, calcium intake according to a food-frequency questionnaire, bone mineral content (BMC; grams), and areal bone mineral density (aBMD; grams per square centimeter), using dual-energy X-ray absorptiometry (DXA) at six skeletal sites. Thirteen preterm girls and 13 age-matched term controls were reassessed 1 year after the first DXA measurement. The former preterm girls were similar to controls in terms of age and height, but were lighter (24.6 +/- 0.6 vs. 27.0 +/- 0.6 kg, p = 0.02). They also reported a higher median calcium intake (1058 vs. 759 mg/day, p = 0.004). aBMD was lower in former preterms compared with controls at the level of the radial metaphysis (0.283 +/- 0.006 vs. 0.298 +/- 0.004, p = 0.04), femoral neck (0.593 +/- 0.011 vs. 0.638 +/- 0.010, p = 0.007), and total hip (0.596 +/- 0.012 vs. 0.640 +/- 0.010, p = 0.007), but was similar between the two groups at the radial diaphysis (0.437 +/- 0.004 vs. 0.436 +/- 0.004) and femoral diaphysis (1.026 +/- 0.015 vs. 1.030 +/- 0.011). Femoral neck aBMD remained lower compared with controls in the subgroup of preterm girls reassessed after 1 year (0.608 +/- 0.017 vs. 0.672 +/- 0.020, p = 0.02). In random effects models for longitudinal data, taking into account the effects of age, weight, and height on aBMD (dependent variable), femoral neck aBMD remained lower in former preterms (p < 0.001). Prepubertal former preterm girls showed growth recovery, but had lower aBMD at the hip and radial metaphysis than age-matched term controls, despite spontaneously higher calcium intake. Preterm girls had similar aBMD results compared with controls at sites with predominantly cortical bone (radial and femoral diaphysis), which are known to be more sensitive to calcium intake.
