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Updated: May 20, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Small-for-gestational-age preterm-born infants already have lower bone mass during early infancy
Monique van de Lagemaat1, Joost Rotteveel, Mirjam M van Weissenbruch
1Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands. m.vandelagemaat@vumc.nl
Insights
Preterm infants who are small-for-gestational-age (SGA) exhibit reduced bone mineral content (BMC) and bone accretion during infancy. This suggests prenatal factors crucial for bone development are not fully compensated for postnatally.
Area of Science:
- Pediatrics
- Neonatology
- Bone Biology
Background:
- Low birth weight in preterm infants is linked to diminished peak bone mass.
- The association between low birth weight and bone mass during infancy remains unclear.
Purpose of the Study:
- To investigate the impact of birth weight on bone accretion in preterm infants from term age to six months post-term.
- To compare bone mineral content (BMC) and accretion in small-for-gestational-age (SGA) versus appropriate-for-gestational-age (AGA) preterm infants.
Main Methods:
- Whole-body bone mineral content (BMC) was measured in 139 preterm infants at term age and six months post-term.
- Infants were categorized at birth as SGA (n=33) or AGA (n=98) based on weight and length SDS.
- Statistical adjustments were made for gender, gestational age, and actual body size.
Main Results:
- SGA infants had significantly lower BMC than AGA infants at term age and six months post-term, even after adjusting for covariates.
- BMC gain between term age and six months post-term was also lower in SGA infants compared to AGA infants.
- This difference in BMC gain persisted even after adjusting for weight and length gain, indicating an independent effect.
Conclusions:
- Small-for-gestational-age preterm infants experience impaired bone accretion in the first six months post-term.
- The findings suggest that the prenatal environment plays a critical role in bone development that cannot be fully replicated postnatally.
- This highlights potential long-term implications for bone health in SGA preterm infants.
Background:
In preterm-born infants, low birth weight and diminished bone accretion deteriorate peak bone mass. Whether low birth weight is already associated with decreased bone mass during infancy is unknown.
Objective:
To study the effect of birth weight on bone accretion between term age (40 weeks postmenstrual age) and six months post-term in preterm-born infants.
Design:
In 139 preterm-born infants (51% male, gestational age 30.3±1.5 weeks, birth weight 1341±288g) weight and whole-body bone mineral content (BMC, gram) were measured at term age and six months post-term. At birth, infants were small-for-gestational-age (SGA, n=33, weight and/or length<-2 SDS) or appropriate-for-gestational-age (AGA, n=98, weight and length≥-2 SDS).
Results:
At term age and six months post-term, BMC adjusted for gender and gestational age was lower in SGA than AGA infants (term age: 38.1±9.5 versus 48.6±10.1g, β=-0.26, 95% CI -0.37; -0.16, p<0.001; six months: 130.1±25.7 versus 145.4±22.9g, β=-0.16, 95% CI -0.25; -0.08, p<0.001). At six months post-term, BMC remained lower in SGA infants after adjustment for actual weight and length. Between term age and six months post-term, BMC gain adjusted for gender and gestational age was lower in SGA than AGA infants (91.7±22.8 versus 98.2±20.7g; β=-0.12, 95% CI -0.24; -0.003, p=0.044). BMC gain remained lower in SGA infants after adjustment for weight and length gain.
Conclusion:
The first six months post-term, SGA preterms have lower bone accretion, independent of body size, suggesting that prenatal conditions for bone accretion cannot be replicated postnatally.
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