Early life factors predict abnormal growth and bone accretion at prepuberty in former premature infants with/without

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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
07:56

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

Published on: January 29, 2018

Dawei Wang1, John Vandermeulen, Stephanie A Atkinson

  • 1Department of Pediatrics, McMaster University, Hamilton, Ontario L8N 3Z5, Canada.

Pediatric Research
|January 11, 2007
PubMed

Insights

Former very low birth weight infants treated with dexamethasone for bronchopulmonary dysplasia exhibit reduced growth and bone mass in prepuberty. Early life factors predict these outcomes, highlighting risks for short stature and low bone mass.

Area of Science:

  • Pediatrics
  • Neonatology
  • Endocrinology

Background:

  • Very low birth weight (VLBW) infants are at risk for growth and bone health issues.
  • Bronchopulmonary dysplasia (BPD) is a common complication in VLBW infants.
  • Dexamethasone (DEX) is sometimes used to treat BPD, but its long-term effects on growth and bone are not fully understood.

Purpose of the Study:

  • To investigate the long-term effects of neonatal dexamethasone (DEX) treatment on growth and body composition in former very low birth weight (VLBW) infants.
  • To identify early life risk factors associated with low bone mass in prepubertal children.
  • To compare growth and body composition between VLBW infants treated with DEX, VLBW infants not treated with DEX, and term-born (TERM) infants.

Main Methods:

  • A longitudinal study involving three groups of children aged 5-10 years: VLBW + DEX, VLBW - DEX, and TERM.
  • Measurements included anthropometry (height, weight) and whole-body bone mineral content, fat mass, and lean mass.
  • Statistical analysis was performed to compare groups and identify risk factors.

Main Results:

  • The VLBW + DEX group showed significantly lower height and weight compared to VLBW - DEX and TERM groups.
  • Both VLBW groups had lower bone mass and lean mass, even after adjusting for height and lean mass, compared to TERM children.
  • A significant proportion (27.9%) of VLBW + DEX children had Z-scores for whole body bone mineral content below -1.5.
  • Earlier gestational age and neonatal BPD treated with DEX were key factors for low bone mass.

Conclusions:

  • Neonatal dexamethasone treatment for bronchopulmonary dysplasia in very low birth weight infants is associated with increased risk of short stature and low bone mass in prepuberty.
  • Early life factors, including gestational age and neonatal interventions, are predictive of growth and bone mass attainment.
  • VLBW infants, particularly those treated with DEX, may be at risk for long-term skeletal health issues, although they might be protected from overweight.

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