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Assessing bone development in preterm infants using quantitative ultrasonography showed a decline in the early
Marieke Krikke1, Dana Yumani1, Christine Rustenburg1
1Department of Neonatology, VU University Medical Center, Amsterdam, The Netherlands.
Insights
Preterm infants exhibit declining bone development markers, metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT), in early postnatal weeks. Gestational age and protein intake influenced these bone health changes.
Area of Science:
- Neonatal Medicine
- Pediatric Bone Health
- Medical Physics
Background:
- Preterm infants are born with suboptimal bone mineral stores.
- Early postnatal bone development is critical for long-term skeletal health.
- Assessing bone development in neonates requires specialized techniques.
Purpose of the Study:
- To investigate bone development in preterm infants during the early postnatal period.
- To evaluate changes in bone parameters using non-invasive ultrasound methods.
- To identify factors influencing bone development in this vulnerable population.
Main Methods:
- Utilized metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) to assess bone development.
- Studied 277 preterm infants admitted to a neonatal intensive care unit.
- Collected data between 2007 and 2012.
Main Results:
- Observed a decline in mcSOS and mcBTT during the first nine postnatal weeks.
- Found significant differences in the pattern of change between infants born before 32 weeks and those born between 28-32 weeks gestation.
- Noted a borderline significant difference in mcBTT change related to protein intake.
Conclusions:
- Preterm infants experience a moderate decline in mcSOS and mcBTT post-birth.
- Further research is needed to understand the clinical significance of this decline.
- Interventions to mitigate this bone loss in preterm infants should be explored.
Aim:
Preterm infants have an insufficient bone mineral store at birth and this study explored their bone development during the early postnatal period.
Methods:
The metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) were used to assess bone development in 277 preterm infants, admitted to the neonatal intensive care unit of the VU University Medical Center, Amsterdam, the Netherlands from 2007-2012.
Results:
During the first nine postnatal weeks, the mcSOS declined from 10 to 38 m per second per week and the mcBTT declined from 20 to 71 nanoseconds per week. The pattern of change in both of these measurements showed a significant difference between infants born before 32 weeks of gestation (p = 0.048) and those born between 28 and 32 weeks of gestation (p = 0.008). There was a borderline significant difference in the pattern of change of the mcBTT in infants with a protein intake below 2 g/kg per day versus a higher intake (p = 0.050).
Conclusion:
The mcSOS and mcBTT of preterm infants showed a small to moderate decline during the early postnatal period. Future studies should explore the clinical relevance of this decline and develop interventions to halt it.
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