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Osteopenia in extremely low birthweight infants
A Horsman1, S W Ryan, P J Congdon
1Department of Medical Physics, General Infirmary, Leeds.
Insights
Extremely low birthweight (ELBW) infants show significant growth in weight and length but lack bone mineral accretion by 39 weeks postconception. These ELBW infants exhibit substantial deficits in bone mineral content compared to full-term infants.
Area of Science:
- Neonatalogy
- Pediatric Endocrinology
- Growth and Development
Background:
- Extremely low birthweight (ELBW) infants face challenges in achieving adequate growth and bone mineralization.
- Understanding the long-term skeletal development of ELBW infants is crucial for optimizing their health outcomes.
Purpose of the Study:
- To assess the growth and bone mineral content of extremely low birthweight (ELBW) infants.
- To compare the physical and skeletal development of ELBW infants with full-term controls.
Main Methods:
- Longitudinal study of 15 ELBW infants and 15 full-term controls.
- Measurements included weight, crown-heel length, and forearm bone mineral content at birth, 8 weeks, and near 40 weeks postconception.
- Statistical analysis to compare growth parameters and bone mineral deficits.
Main Results:
- ELBW infants demonstrated catch-up growth in weight and length between 32 and 39 weeks postconception.
- No significant bone mineral accretion was observed in ELBW infants during the study period.
- At 39 weeks, ELBW infants were significantly lighter, shorter, and had a substantial bone mineral deficit compared to controls.
Conclusions:
- ELBW infants experience catch-up growth but fail to achieve adequate bone mineralization by term-equivalent age.
- Significant bone mineral deficits persist in ELBW infants, suggesting potential long-term skeletal health risks.
- Further research is needed to investigate interventions to improve bone health in ELBW populations.
Abstract:
Fifteen extremely low birthweight (ELBW) white infants (those weighing 1000 g or less) were observed at birth, within eight weeks of birth and near 40 weeks postconception. On the second and third occasions, weight, crown-heel length, and bone mineral content of their forearms were measured. Fifteen infants born at full term on whom similar measurements were made soon after birth acted as controls. Between 32 and 39 weeks the median weight of ELBW infants increased from 970 g to 1850 g and crown-heel length from 35.7 cm to 41.0 cm. There was no evidence, however, of bone mineral accretion in the measurement region; initial and final median measurements of bone mineral content were 76 mg/cm and 86 mg/cm, the median individual difference being only 4 mg/cm with an interquartile range of 25 mg/cm. Median weight, crown-heel length, and bone mineral content of the control group were 3270 g, 50.6 cm, and 196 mg/cm, respectively. Compared with the controls, ELBW infants at 39 weeks were a median (interquartile range) of 1420 (525) g lighter, 9.9 (3.9) cm shorter, and had a bone mineral content deficit of 108 (32) mg/cm. In terms of weight and crown-heel length ELBW infants at 39 weeks were comparable with infants born and observed at 32 weeks' gestation; compared with these infants the bone mineral content deficit in the ELBW group was about 33%.