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Breech presentation is associated with lower adolescent tibial bone strength
J H Tobias1, A Sayers1, K C Deere1
1Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Summary
Breech presentation in utero is linked to reduced bone development in adolescents, affecting tibia bone mineral content and density. These effects on skeletal size and strength may persist long-term, influencing adolescent bone health.
Area of Science:
- Orthopedics
- Pediatric Endocrinology
- Developmental Biology
Background:
- Breech position is associated with altered fetal movement and limb joint stresses.
- Neonatal bone mineral content and area are lower in breech presentation at birth.
- Long-term skeletal effects of breech presentation into adolescence are not well understood.
Purpose of the Study:
- To investigate the association between birth presentation (breech vs. cephalic) and bone outcomes in adolescents.
- To determine if reduced bone outcomes associated with breech presentation persist into later life.
- To examine tibia and hip bone parameters in relation to fetal presentation.
Main Methods:
- A UK prospective birth cohort of 1971 participants (1062 females) at age 17 years was analyzed.
- Tibia bone outcomes (cortical BMC, CSA, BMD, periosteal circumference, CSMI) were measured using pQCT.
- Hip bone outcomes (BMC, bone area, BMD, CSMI) were measured using DXA.
Main Results:
- Breech presentation was associated with lower tibia cortical bone mineral content (BMC), cross-sectional area (CSA), bone mineral density (BMD), periosteal circumference, and cross-sectional moment of inertia (CSMI).
- Females with breech presentation showed significantly lower hip CSA.
- Associations remained consistent after adjusting for multiple potential confounders and mediators.
Conclusions:
- Prenatal loading conditions associated with breech presentation may have lasting effects on adolescent skeletal size and strength.
- These findings highlight potential long-term influences of fetal positioning on bone development.
- Further research is needed to replicate these findings and understand the mechanisms involved.
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