Related Experiment Videos
Bone growth with low bone mineral content in very low birth weight premature infants
Insights
Very low birth weight infants show delayed bone growth in the first 10 weeks of life. Bone mineral content remained constant, while bone width increased, leading to a decreased bone mineral content to bone width ratio.
Area of Science:
- Neonatal Medicine
- Pediatric Bone Health
- Growth and Development
Background:
- Very low birth weight (VLBW) infants (<1300g, <32 weeks gestation) are at high risk for metabolic bone disease.
- Bronchopulmonary dysplasia (BPD) is common in VLBW infants and associated with poor bone health outcomes.
- Intrauterine bone growth rates serve as a benchmark for assessing neonatal bone development.
Purpose of the Study:
- To assess serial bone mineral content (BMC) and bone width (BW) in VLBW infants during the first 10 weeks of life.
- To compare bone growth parameters between VLBW infants with and without bronchopulmonary dysplasia (BPD).
- To evaluate the ratio of BMC to BW as an indicator of bone apposition and mineralization.
Main Methods:
- Serial photon absorptiometry measurements of the left radius in 38 VLBW infants (birth weight <1300g, gestational age <32 weeks) over 10 weeks.
- Comparison of bone growth between 15 infants with BPD and 23 infants without BPD.
- Measurement of BMC in 175 infants to establish intrauterine growth rates for comparison.
Main Results:
- BMC remained relatively constant and significantly below intrauterine rates in both control and BPD groups throughout the 10-week period.
- Bone width (BW) increased significantly in both groups but remained significantly delayed compared to intrauterine rates.
- The ratio of BMC:BW decreased in both groups, indicating slower mineralization relative to bone apposition, with a more pronounced decrease in the BPD group.
Conclusions:
- VLBW infants experience significantly delayed bone growth, characterized by static BMC and lagging BW, compared to intrauterine rates.
- The decreasing BMC:BW ratio suggests impaired bone mineralization in early postnatal life for VLBW infants.
- While BPD infants were smaller, their bone growth parameters (BMC, BW, BMC:BW ratio) were not significantly different from non-BPD VLBW infants during the first 10 weeks, despite the known association with metabolic bone disease.
Abstract:
We report serial measurements of bone mineral content (BMC), bone width (BW, a measure of appositional bone growth), and the ratio of BMC:BW by photon absorptiometry of the left radius through the first 10 wk of life in 38 very low birth weight premature infants (birth weight less than 1300 g, gestational age less than 32 wk). Fifteen of 38 infants developed bronchopulmonary dysplasia (BPD) and as a group they could not be distinguished from the 23 infants without BPD, despite the high association between BPD and metabolic bone disease. As BPD occurred in the smaller patients, the BPD group had a significantly lower mean birth weight and mean gestational age as compared to controls (950 +/- 125 g versus 1119 +/- 149, and 28.0 +/- 0.8 versus 29.0 +/- 1.3 wk). For both control and BPD groups, BMCs did not differ and remained relatively unchanged throughout the first 10 wk of life, lagging significantly behind the intrauterine rate as defined by measuring BMC in 175 infants of varying gestational ages during the first few days of life. BW also did not differ during this period between groups. BW did increase significantly in both groups (from 3.2 +/- 0.3 to 3.9 +/- 0.4 mm in the controls and from 3.0 +/- 0.3 to 3.8 +/- 0.4 mm in the BPD group), but remained significantly delayed compared to the intrauterine rate. In both groups, BMC remained relatively constant despite increasing BW and thus BMC/BW decreased during the first 10 wk of life (from 11.5 +/- 1.3 to 10.2 +/- 1.9 in the controls and from 11.0 +/- 1.3 to 8.6 +/- 2.2 in the BPD group).(ABSTRACT TRUNCATED AT 250 WORDS)