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Published on: January 29, 2018
Radiological evaluation of bone growth in neonates born at gestational ages between 26 and 41 weeks: cross-sectional
Shin-Lin Shih1, Yann-Jinn Lee, Fu-Yuan Huang
1Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Radiology, Taipei Medical University, Taipei, Taiwan. mmh80@ms2.mmh.org.tw
Insights
This study tracked bone growth in premature infants, finding that vertebral body L1 and long bone lengths increase weekly. A significant growth spurt in L1 was observed around 34 weeks of gestational age for both sexes.
Area of Science:
- Neonatal medicine
- Pediatric orthopedics
- Radiology
Background:
- Neonatal intensive care unit (NICU) admissions often involve premature infants with respiratory distress.
- Accurate assessment of growth and development in premature neonates is crucial for clinical management.
- Long bone and vertebral ossification provide key indicators of skeletal maturation.
Purpose of the Study:
- To measure and analyze the growth of the ossified portions of the humerus, femur, and the L1 vertebral body in neonates.
- To establish normative growth data for these skeletal elements based on gestational age (GA).
- To investigate sex-based differences and identify growth spurts in skeletal development.
Main Methods:
- Radiographic measurements of humerus, femur, and L1 vertebral body length were taken from 347 neonates (26–41 weeks GA).
- Infants with anomalies or multiple births were excluded.
- Weekly growth increments and length ratios were calculated and analyzed by sex and GA.
Main Results:
- Average weekly increments: L1 (0.23 mm males, 0.20 mm females), humerus (1.82 mm males, 1.54 mm females), femur (2.35 mm males, 2.30 mm females).
- The L1 to body length ratio increased with GA, with a growth spurt at 34 weeks GA for both sexes.
- Long bone growth was similar in both sexes before 36 weeks GA; femur to body length ratio increased in males after 36 weeks.
Conclusions:
- Radiographic skeletal measurements provide valuable data for assessing growth in neonates.
- Specific growth patterns and spurts in L1 and long bones are identifiable and sex-dependent after 36 weeks GA.
- These findings contribute to understanding normal skeletal maturation in the NICU population.
Abstract:
The length of the ossified part of the long bones of the upper (humerus) and lower limb (femur) as well as the axial length (that is, height) of the vertebral body of L1 were measured on a plain supine radiograph in 347 newborn babies (228 males, 119 females) with the gestational age (GA) from 26 to 41 weeks. All were admitted to the neonatal intensive care unit. Reasons for admission included hyaline membrane disease, meconium aspiration syndrome, neonatal asphyxia or transient tachypnea of the newborn. Patients with abnormal growth, gross anomalies, or who were the products of multiple births were excluded. The average weekly increment in the height of L1 for male infants born at GA varying from 26 to 41 weeks was 0.23 mm, for the humerus 1.82 mm and for the femur 2.35 mm. The corresponding data for females was 0.20 mm, 1.54 mm and 2.30 mm. The ratio of the height of L1 to body length progressively increased between 26 to 41 weeks. A growth spurt in L1 was noted for both sexes at 34 weeks of GA. Long bone growth was similar in male and female infants born before 36 weeks. However, the ratio of femur to body length in males increased after 36 weeks. The ratio of humerus to body length remained constant over the entire range of GA.
