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[Examination of infant bone status with quantitative ultrasound at birth]
Xiang-peng Liao1, Wei-li Zhang, Jia-min He
1Department of Nutrition and Gastroenterology, Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Second Medical University, Shanghai 200092, China.
Insights
Quantitative ultrasound (QUS) offers a safe, non-invasive method to assess infant bone health. Premature infants and seasonal birth factors significantly influence bone speed of sound (SOS) in newborns.
Area of Science:
- Pediatrics
- Biophysics
- Neonatology
Background:
- Fetal and early neonatal bone nutrition is critical for lifelong skeletal development.
- Quantitative ultrasound (QUS) is an emerging, non-invasive technique for assessing bone status in children.
- Evaluating bone mineral density and strength in neonates is essential for early identification of potential issues.
Purpose of the Study:
- To evaluate the clinical application of QUS in newborn infants.
- To establish normative QUS data for normal neonates, including premature infants.
- To assess factors influencing bone status in the neonatal period.
Main Methods:
- Utilized an Omnisense ultrasound bone sonometer to measure bone speed of sound (SOS) in the tibia.
- Included 157 neonates, with 68 premature infants, within the first week of life.
- Analyzed data considering sex, gestational age, birth weight, and birth season.
Main Results:
- No significant sex-based differences in SOS were observed.
- Premature infants exhibited significantly lower SOS compared to full-term infants (P=0.005).
- Birth season influenced SOS, with lower values in spring and summer births (P=0.010).
- Significant correlations between SOS, gestational age, and birth weight were found in appropriate-for-gestational-age infants.
- Gestational age and birth season were identified as key contributors to neonatal bone SOS.
Conclusions:
- QUS is a suitable, radiation-free, and portable method for neonatal bone status evaluation.
- Premature infants require specific attention regarding their bone status.
- Vitamin D supplementation for pregnant women may be beneficial for neonatal bone health.
Objective:
Quantitative ultrasound (QUS) is a new method of evaluating Children's bone status, including bone mineral density and bone strength. The bone nutrition during fetal and early neonatal period is very important for the human bone development of whole life. The objective of this study was to evaluate the clinical application of QUS for newborn infants and to obtain the QUS data for normal neonates including premature infants.
Methods:
An ultrasound bone sonometer, Omnisense, produced by Sunlight company of Israel, was applied to measure the bone speed of sound (SOS) of tibia in 157 neonates including 68 premature infants in the first week of life.
Results:
(1) No significant difference in SOS was found between male (n = 88, SOS = 2968 +/- 115 m/s) and female infants (n = 69, SOS = 2956 +/- 105 m/s) (P = 0.524). The SOS of premature infants (n = 68, mean gestational age 33.0 +/- 2.5 weeks) and full-term infants (n = 89, mean gestational age of 39.4 +/- 1.3 weeks) were 2935 +/- 96 m/s and 2984 +/- 116 m/s, respectively, at birth and there was significant difference between them (P = 0.005). (2) There were significant differences of SOS in neonates who were born in different seasons (F = 4.377, P = 0.005); the significant difference remained (F = 3.933, P = 0.010) after the influences of gestational age and birth weight were eliminated. The SOS in neonates born in spring (March, April and May) and summer (June, July and August) were significantly lower than that of those born in autumn (September, October and November) and winter (December, January and February). The SOS in neonates born in summer was about 2.3% (75/2999) was lower than that of those born in winter. (3) Significant difference of SOS was observed between neonates with different birth weight [< 1500 g (n = 11), SOS = 2968 +/- 115 m/s; and > 2500 g (n = 86), SOS = 2980 +/- 113 m/s; P = 0.042]. (4) Significant correlations were found between SOS and gestational age (r = 0.270, P = 0.005), and between bone SOS and birth weight (r = 0.232, P = 0.015) in appropriate for gestational age (AGA) infants (n = 109); however, no such significant correlations were found in small for gestational age (SGA) infants or large for gestational age (LGA) infants. Multiple regression analysis showed that gestational age and the birth season were two important factors which may contribute to bone SOS of neonates at birth (n = 157, F = 8.515, P < 0.001, adjusted R(2) = 0.141), when the analysis was carried out with SOS as dependent variable and gestational age, birth weight, chronological age, calf length and the birth season as independent variables.
Conclusion:
QUS is a new method which is suitable for evaluating the bone status of neonates and it is free of radiation, non-invasive, the machine is portable and easy to manipulate at infant bed side. The present study suggests the need for particular care for the bone status in premature infants and supplement of vitamin D in pregnant women.
