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Spontaneous resolution of bone mineral depletion in preterm infants
P J Congdon1, A Horsman, S W Ryan
1General Infirmary, Leeds.
Insights
Preterm infants show a rapid bone mineral accretion phase starting around 40 weeks postconception. This catch-up growth significantly reduces the perinatal bone mineral deficit compared to full-term infants.
Area of Science:
- Neonatalogy
- Pediatric Bone Health
- Perinatal Medicine
Background:
- Preterm infants often experience a perinatal mineralisation deficit due to early birth.
- Accurate assessment of bone mineral content and accretion rates is crucial for monitoring growth in neonates.
Purpose of the Study:
- To compare bone mineral content and accretion rates between preterm and full-term infants.
- To identify the onset and significance of mineral accretion phases in preterm neonates.
Main Methods:
- Single photon absorptiometry was used to measure mid-forearm bone mineral content.
- Examinations were conducted on preterm (25-34 weeks GA) and full-term (38-42 weeks GA) infants at two postconceptional age intervals.
- Bone mineral accretion rates were calculated and compared between the two groups.
Main Results:
- Preterm infants had significantly lower bone mineral content at initial examination compared to full-term infants.
- Preterm infants exhibited a significantly higher mean rate of mineral accretion (8.70 mg/cm/week) than full-term infants (1.60 mg/cm/week).
- A rapid mineral accretion phase was observed in preterm infants starting around 40 weeks' postconception.
Conclusions:
- Preterm infants demonstrate a catch-up phase of rapid bone mineral accretion post-40 weeks' postconception.
- This accelerated accretion effectively mitigates the initial perinatal mineralisation deficit.
- Findings highlight the importance of monitoring bone health in preterm neonates for optimal development.
Abstract:
Fifteen preterm infants and 17 born at full term whose gestational ages ranged from 25 to 34 weeks and 38 to 42 weeks, respectively, were examined initially at postconceptional ages ranging from 38 to 44 weeks and subsequently at 46 to 71 weeks. Each examination included measurement of bone mineral content of the mid-forearm by single photon absorptiometry. For the preterm group, the mean (SD) value of bone mineral content at the first examination was 109.0 (27.6) mg/cm and was significantly lower than the corresponding value of 194.4 (19.6) mg/cm for the whole full term group. The mean subsequent rate of mineral accretion in the preterm group was 8.70 (4.60) mg/cm/week, the mean individual duration of observation being 9.7 weeks. Rate of mineral accretion for the full term group was independent of the duration of observation and averaged 1.60 (2.20) mg/cm/week. The difference between mean values of rate of mineral accretion in the preterm and full term groups was highly significant. Our results show that there is a phase of rapid mineral accretion starting at 40 weeks' postconception in preterm infants that substantially reduces the perinatal mineralisation deficit.