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Evaluation of bone metabolism in newborn twins using quantitative ultrasound and biochemical parameters
Semra Kara1, Nilüfer Güzoğlu2, Emine Göçer3
1a Turgut Özal University Medical Faculty, Department of Neonatology , Ankara , Turkey .
Insights
Metabolic bone disease (MBD) in premature infants can be influenced by various factors. This study found maternal drug use and phosphorus levels negatively impact bone health, while assisted reproductive techniques may enhance it.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Biochemistry
Background:
- Metabolic bone disease (MBD) is a significant complication in premature infants.
- Early nutritional support is crucial for mitigating MBD and its complications.
Purpose of the Study:
- To evaluate bone metabolism in twin infants using biochemical markers and quantitative ultrasound (QUS).
- To compare bone metabolism between co-twins.
- To identify risk factors affecting MBD in twins.
Main Methods:
- Assessed serum calcium, phosphorus, magnesium, and alkaline phosphatase in 43 twin pairs.
- Measured bone mineral density using QUS (speed of sound, SOS) at postnatal 30 days.
- Analyzed factors influencing SOS, including maternal and infant characteristics, and nutritional interventions.
Main Results:
- Higher birth weight and head circumference were noted in one twin group, but no significant differences in biochemical parameters or SOS.
- Maternal drug use and phosphorus levels were identified as significant risk factors negatively impacting SOS.
- Pregnancy resulting from assisted reproductive techniques was associated with enhanced SOS.
Conclusions:
- Bone metabolism in premature twins is influenced by specific maternal and infant factors.
- Phosphorus levels and maternal drug use are detrimental to bone health in this population.
- Assisted reproductive technology may have a protective effect on bone development in premature infants.
Abstract:
Metabolic bone disease (MBD) is one of the important complications of prematurity. Early and adequate nutritional interventions may reduce the incidence and potential complications of MBD. The present study aimed to evaluate bone metabolism in twins via biochemical parameters and quantitative ultrasound (QUS) and to compare the results between twin pairs. Moreover, twin infants were evaluated in terms of potential risk factors likely to have impact on MBD. Forty-three pairs of twins were included in the study. Serum calcium, phosphorus, magnesium, and alkaline phosphatase concentrations were assessed and bone mineral density was measured using QUS (speed of sound, SOS) at postnatal 30 d. Co-twin with the higher birth weight was assigned to Group 1 (n = 36) and the other twin was assigned to Group 2 (n = 36). Birth weight and head circumference were significantly higher in the infants of Group 1 compared with Group 2. No significant difference was found among the groups in terms of gender, history of resuscitation, length of stay in intensive care unit (ICU) or in the incubator, duration of total parenteral nutrition (TPN), type of nutrition, vitamin D use, biochemical parameters, and the SOS value. The factors likely to affect SOS, including type of pregnancy, maternal drug use, gender of infant, birth weight, head circumference at birth, gestational week, length of stay at the ICU, duration of TPN, type of nutrition, resuscitation, vitamin D use, and levels of calcium, phosphorus, magnesium, and alkaline phosphatase were entered into the model. The phosphorus level and the maternal drug use were found to be the factors that significantly reduced SOS, whereas pregnancy after assisted reproductive techniques was found to be a significant enhancing factor.
