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Published on: January 29, 2018
Walking age does not explain term versus preterm difference in bone geometry
Haifa Abou Samra1, Bonny Specker
1EA Martin Program in Human Nutrition, South Dakota State University, Brookings, SD 57007, USA.
Insights
Former preterm boys exhibit distinct bone geometry, with larger bone circumference and thinner cortical bone, linked to activity levels, not walking age. These bone differences were not observed in girls.
Area of Science:
- Pediatric Bone Health
- Developmental Pediatrics
- Orthopedic Research
Background:
- Preterm birth can impact long-term skeletal development.
- Understanding bone geometry differences in relation to developmental milestones is crucial.
Purpose of the Study:
- To investigate the association between bone geometry and the onset of walking in children born at term versus preterm.
- To determine if differences in walking age explain bone geometry variations.
Main Methods:
- Cross-sectional study of 128 preschool children (3-5 years).
- Peripheral quantitative computerized tomography (pQCT) used for distal tibia bone size assessment.
- Linear models stratified by sex analyzed bone geometry in relation to birth status and walking age.
Main Results:
- Children born preterm walked later than term-born children, but gestation-corrected walking age did not differ.
- Preterm boys showed larger periosteal and endosteal circumferences and smaller cortical thickness and area compared to term-born boys.
- These bone differences in preterm boys remained significant after accounting for walking age but were explained by current activity levels.
Conclusions:
- Former preterm boys, unlike girls, displayed altered bone geometry (larger circumference, thinner cortex).
- These bone geometry differences in preterm boys are primarily attributed to current physical activity levels.
- Walking age does not appear to be the primary driver of observed bone geometry differences in former preterm children.
Objective:
To elucidate the relationship between bone geometry and onset of walking in former term and preterm children.
Study Design:
We conducted a cross-sectional study of 128 preschool children aged 3 to 5 years who underwent peripheral quantitative computerized tomography measures of bone size at the distal tibia. Linear models were developed, stratifying by sex, to determine whether bone differences between children born term and preterm were caused by differences in walking age.
Results:
Children with a history of preterm birth walked later than children born at term (12.4 +/- 0.5 versus 10.9 +/- 0.2 months; P = .004); however, gestation-corrected walking age (11.4 +/- 0.5 for children born preterm) did not differ. In multiple regression analysis, boys born preterm had larger periosteal and endosteal circumferences and smaller cortical thickness and area than boys born term (least square means, 49.7 +/- 1.3 mm, 43.0 +/- 1.8 mm, 1.1 +/- 0.11 mm, and 49.3 +/- 3.2 mm2 versus 47.0 +/- 0.5 mm, 38.5 +/- 0.7 mm, 1.4 +/- 0.04 mm, and 56.9 +/- 1.2 mm2, respectively; all P < .05). Preterm birth remained statistically significant after adding the age of walking to the models, but no longer significant when current activity levels were included.
Conclusion:
Greater periosteal and endosteal circumferences, with smaller cortical bone thickness and area, were found in former preterm boys, but not girls, and were explained by differences in current activity levels, not age of walking.
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