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Longitudinal measurements of bone status in preterm infants
Terri Ashmeade1, Lourdes Pereda, Maggie Chen
1Department of Pediatrics, University of South Florida College of Medicine, Tampa, FL 33606, USA. tashmead@health.usf.edu
Insights
Bone speed of sound (SOS) in preterm infants declines during hospitalization, indicating reduced bone strength. Longitudinal SOS measurements may help identify infants at risk for osteopenia of prematurity.
Area of Science:
- Neonatal Medicine
- Pediatric Bone Health
- Diagnostic Ultrasound
Background:
- Quantitative ultrasound (QUS) assessment of bone speed of sound (SOS) is explored for evaluating bone status in preterm infants.
- Limited research exists on longitudinal SOS measurements in this vulnerable population.
Purpose of the Study:
- To evaluate longitudinal changes in bone SOS in preterm infants.
- To compare bone SOS between preterm and term infants.
Main Methods:
- Sixty preterm infants (<33 weeks gestational age) and 48 term infants were enrolled.
- Tibia SOS was measured within the first week of life for preterm infants and within 72 hours for term infants.
- Weekly SOS measurements were taken for 29 preterm infants across three gestational age groups during hospitalization.
Main Results:
- Preterm infants exhibited significantly lower median SOS values compared to term infants (2,924 vs. 3,036 m/sec).
- SOS values decreased significantly over time in preterm infants, particularly in those born earlier (24-29 weeks gestational age).
- A negative correlation was observed between serum alkaline phosphatase and SOS, and a positive correlation between serum phosphorus and SOS.
Conclusions:
- Tibia SOS measurements decline during hospitalization in preterm infants, suggesting progressive bone strength loss.
- Longitudinal bone SOS monitoring, alongside serum alkaline phosphatase and phosphorus levels, can help identify infants at risk for osteopenia of prematurity.
Background:
Quantitative ultrasound measurement of the speed of sound (SOS) through bone has been investigated as a means of assessing bone status in preterm infants. Few studies report longitudinal measurements.
Objective:
To assess longitudinal changes in bone SOS in preterm infants.
Methods:
Sixty preterm infants with gestational ages of < 33 weeks and with birth weight appropriate for gestational age (AGA), and 48 healthy, term AGA infants were enrolled. SOS measurements of the tibia were made within the first week of life in the preterm infants, and within the first 72 hours of life in the term infants. During their hospital stay, weekly measurements of tibial SOS were made in 29 of the preterm infants, who were divided into three gestational age groups: Group 1: 24-26 weeks (n = 8), Group 2: 27-29 weeks (n = 9), and Group 3: 30-32 weeks (n = 12).
Results:
The median SOS value for the 60 newborn preterm infants was significantly lower than that for the 48 newborn term infants (2,924 versus 3,036 m/sec, p < 0.001). At each time point, SOS values for each of the preterm infant gestational age groups were significantly lower than the term newborn infant SOS values. SOS values decreased significantly over time for the entire cohort of 29 preterm infants (p < 0.001), and for Groups 1 (p = 0.015) and 2 (p = 0.003). At several time points, there was a significant negative correlation between serum alkaline phosphatase levels and SOS values, and a significant positive correlation between serum phosphorus levels and SOS values.
Conclusion:
SOS measurements of the tibia decline during hospitalization in preterm infants, suggesting a progressive loss of bone strength. Longitudinal measurements of bone SOS in combination with serum alkaline phosphatase and serum phosphorus levels may identify infants at risk of developing osteopenia of prematurity.
