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Published on: January 29, 2018
Body composition and bone mass among 5-year-old survivors of necrotizing enterocolitis
Amanda Magnusson1,2, Diana Swolin-Eide1,2, Anders Elfvin3,4
1Department of Pediatrics, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Necrotizing enterocolitis (NEC) survivors born preterm showed reduced growth and altered body composition by age 5. These children also had lower bone mass, indicating a need for monitoring growth and bone health.
Area of Science:
- Pediatrics
- Neonatology
- Pediatric Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a severe intestinal disease affecting preterm infants.
- Preterm infants are already at risk for poor bone mineralization.
- NEC may further compromise mineral absorption, increasing bone health risks.
Purpose of the Study:
- To assess long-term growth, bone mineral density (BMD), bone mineral content (BMC), and body composition at 5 years of age in preterm infants with a history of NEC.
- To compare outcomes in NEC survivors to matched controls born preterm without NEC.
Main Methods:
- A longitudinal follow-up study involving 50 Swedish children born before 37 weeks gestation.
- 25 NEC cases (minimum stage IIA) and 25 matched controls were assessed.
- Dual-energy X-ray absorptiometry (DXA) was used to measure body composition, BMC, and BMD.
Main Results:
- NEC survivors had significantly lower weight ( -1.3 SDS vs -0.7 SDS) and reduced fat mass (23.4% vs 29.1%) compared to controls.
- Lower total body bone mineral content (BMC) (355.6g vs 416.7g) was observed in NEC cases.
- NEC survivors exhibited lower BMD Z-scores for the total body (excluding head) and lumbar spine.
Conclusions:
- Preterm infants with a history of NEC demonstrate impaired growth, altered body composition, and diminished bone mass by age 5.
- These findings highlight the critical need for specialized monitoring of growth and bone health in NEC survivors during childhood.
- Early identification and intervention are crucial for managing long-term health outcomes in this vulnerable population.
Background:
Necrotizing enterocolitis (NEC) affects the intestine of preterm infants. Preterm infants risk inadequate bone mineralization. This risk may increase if the intestinal uptake of minerals is affected after NEC.
Methods:
This is a study of growth, bone mineral density (BMD), bone mineral content (BMC), and body composition at 5 years of age among Swedish children born before gestational week 37 + 0 with a history of NEC, minimum stage IIA, compared to matched controls. Fifty children, 25 NEC cases and 25 controls, were examined with dual energy X-ray absorptiometry (DXA) and DXA with laser.
Results:
The NEC cases had lower weight, -1.3 SDS vs -0.7 SDS, a lower fat mass and fat percent, 23.4 vs 29.1%, compared to the controls. NEC cases had lower BMC total body head excluded, 355.6 g vs 416.7 g. BMD Z-scores were lower among NEC cases in total body head excluded, -0.7 vs -0.1, and in lumbar spine.
Conclusions:
Preterm NEC survivors at 5 years of age had reduced growth, an altered body composition, and indications of a lower bone mass compared to matched controls. The study suggests that preterm infants diagnosed with NEC need special attention during childhood regarding growth and bone health.
Impact:
A follow-up longitudinal study of growth, bone health, and body composition at 5 years of age among children born preterm with a history of NEC compared to matched controls. The NEC cases had lower weight than controls. NEC cases had an altered body composition with lower fat mass compared to controls. The DXA results showed that the NEC cases had lower bone mineral content and a tendency to lower bone mineral density. The study suggests that preterm infants diagnosed with NEC need special attention at follow-up regarding growth and bone health compared to preterm infants without NEC.
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