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Updated: Nov 11, 2025
Imaging of the Microstructural Failure Mechanism in the Human Hip
Published on: September 29, 2023
Associations between prenatal indicators of mechanical loading and proximal femur shape: findings from a
Monika Frysz1,2, Jon H Tobias1,2, Deborah A Lawlor2,3,4
1Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK.
Insights
Prenatal conditions like oligohydramnios (low amniotic fluid) can alter adolescent hip shape, particularly in males. These findings highlight the impact of early mechanical loading on joint development.
Area of Science:
- Developmental biology
- Orthopedics
- Prenatal medicine
Background:
- Hip development is significantly influenced by mechanical loading.
- The relationship between prenatal mechanical loading and later-life hip shape is not well understood.
Purpose of the Study:
- To investigate the association between prenatal loading indicators and hip shape in adolescence.
- To explore how factors like gestation length, oligohydramnios, and breech presentation affect hip morphology.
Main Methods:
- Utilized data from the UK Avon Longitudinal Study of Parents and Children (ALSPAC).
- Examined prenatal indicators (gestation length, oligohydramnios, breech) from obstetric records.
- Analyzed hip shape modes (HSMs) from DXA scans at ages 14 and 18 years in over 2000 participants.
- Employed confounder-adjusted models to assess associations.
Main Results:
- Oligohydramnios was linked to significant alterations in hip shape at both 14 and 18 years.
- Specific hip shape modes (e.g., wider femoral neck and head) were associated with oligohydramnios.
- Associations were generally more pronounced in males and with oligohydramnios compared to gestation length or breech presentation.
Conclusions:
- Prenatal skeletal loading, especially oligohydramnios, appears to influence adolescent hip joint shape.
- These findings suggest a potential long-term impact of the intrauterine environment on musculoskeletal development.
- The study underscores the importance of considering prenatal conditions in understanding variations in hip morphology.
Objectives:
Hip development is influenced by mechanical loading, but associations between prenatal loading and hip shape in later life remain unexplored.
Methods:
We examined associations between prenatal loading indicators (gestation length, oligohydramnios (OH) and breech) obtained from obstetric records and hip shape modes (HSMs) generated using dual-energy X-ray absorptiometry images taken at age 14- and 18-years in participants from the UK Avon Longitudinal Study of Parents and Children (ALSPAC). These associations were examined in 2453 (30 OH, 105 breech) and 2330 (27 OH, 95 breech) participants with complete data at age 14- and 18-years respectively using confounder-adjusted models.
Results:
At 14 years HSM2 was 0.59SD lower in OH males, and HSM5 (-0.31SD) and HSM9 (-0.32SD) were lower in OH in both sexes. At 18 years HSM1 (-0.44SD) and HSM2 (-0.71SD) were lower and HSM6 (0.61SD) and HSM8 (1.06SD) were higher in OH males, whilst HSM5 was lower in OH in both sexes. OH appeared to be associated with a wider femoral neck and head, and larger lesser/greater trochanters. Only weak associations were observed between gestation length/breech and HSMs.
Conclusions:
These results suggest that prenatal skeletal loading, in particular oligohydramnios, may influence adolescent joint shape with associations generally stronger in males.
