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Preterm birth and the future risk of orthopedic fracture

Jonathan Michaud1,2,3, Thuy Mai Luu4, John C LeBlanc5

  • 1Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada.

Pediatric Research
|January 23, 2020
PubMed

Insights

Preterm birth increases the risk of childhood fractures, particularly femur and assault-related fractures. This elevated risk is most pronounced before 18 months of age, highlighting the need for fracture prevention strategies in preterm infants.

Area of Science:

  • Pediatrics
  • Orthopedics
  • Public Health

Background:

  • Preterm birth occurs during a critical window for bone mineralization.
  • Understanding the long-term skeletal health implications of preterm birth is crucial.

Purpose of the Study:

  • To investigate the association between preterm birth and the risk of childhood fracture hospitalizations.
  • To determine if the risk of fracture varies by the child's age.

Main Methods:

  • A large cohort study of 788,903 infants born in Quebec, Canada (2006-2016).
  • Exposure defined as preterm birth (<37 weeks gestation).
  • Outcome assessed as any hospitalization for fracture before 2018, analyzed using adjusted Cox regression models.

Main Results:

  • Fracture hospitalization incidence was higher in preterm (17.9/10,000 person-years) versus term infants (15.3/10,000 person-years).
  • Preterm children had a 1.27-fold increased risk of femur fractures and a 2.27-fold increased risk of assault-related fractures.
  • The risk for femur fractures was significantly higher between 6 and 17 months of age (2.20-fold increased risk).

Conclusions:

  • Preterm birth is linked to a higher risk of hospitalization for femur and assault-related fractures in childhood.
  • These fracture risks are particularly elevated in the first 18 months of life.
  • Families of preterm infants should receive targeted counseling and support for fracture prevention.
Abstract

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