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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Bone mineral density at age 5 years in very preterm-born children compared to term-born children
A M le Clercq1, D J Dorrepaal2, G F Hasperhoven1
1Department of Neonatal and Pediatric Intensive Care, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
Insights
Very preterm birth (VPB) children showed lower bone mineral density (BMD) at age 5, but this difference disappeared after accounting for body size. This suggests altered growth, not bone mineralization issues, may explain bone density differences in VPB survivors.
Area of Science:
- Pediatrics
- Neonatology
- Skeletal Development
Background:
- Very preterm birth (VPB, <32 weeks gestation) is linked to impaired skeletal development due to reduced extrauterine bone mineralization.
- Neonatal Intensive Care Unit (NICU) nutrition protocols aim to support bone mineral density (BMD) in VPB infants.
Purpose of the Study:
- To evaluate if the NICU nutrition protocol adequately supports BMD in VPB children.
- To compare BMD at age 5 years between VPB children and term-born children.
Main Methods:
- Prospective cohort study comparing 94 VPB children and 259 term-born children.
- Dual-energy X-ray Absorptiometry (DXA) measured total body less head (TBLH) BMD at age 5.
- Standard Deviation Scores (SDSs) and multiple regression analyses were used to compare BMD and identify associated factors.
Main Results:
- VPB children had lower mean height, weight, fat mass, and lean body mass SDS at age 5.
- VPB children exhibited significantly lower BMDTBLH and a higher prevalence of low BMD compared to term-born peers.
- After adjusting for body size, the difference in BMDTBLH between VPB and term-born children was no longer significant.
Conclusions:
- VPB children had lower BMDTBLH at age 5, though within the normal range.
- Lower height and lean body mass SDS in VPB children explained the observed BMD differences.
- Findings suggest altered growth, rather than anomalous bone mineralization, may underlie bone density variations in VPB survivors.
Background & Aims:
Very preterm birth (VPB, <32 weeks gestation) affects skeletal development due to decreased extrauterine bone mineralization. To assess whether our Neonatal Intensive Care Unit (NICU) nutrition protocol adequately supports bone mineral density (BMD) development in VPB children, we compared BMD around age 5 years in VPB children versus term-born children.
Methods:
In this prospective cohort study, BMD of the total body less head (TBLH) was measured in 94 VPB children and 259 term-born children by Dual-energy X-ray Absorptiometry (DXA) at age 5 years. Age- and sex-adjusted Standard Deviation Scores (SDSs) were calculated for BMDTBLH and compared between groups. Multiple regression analyses were performed to evaluate which variables associated with BMDTBLH in VPB children.
Results:
At age 5 years, VPB children had lower mean (SD) height, weight, fat mass (FM) and lean body mass (LBM) SDS and had a lower BMDTBLH compared to term-born children (-0.41 (1.17) vs. 0.04 (1.08), p < 0.001). Moreover, the prevalence of low BMDTBLH (<-2 SDS) was higher in VPB children (8.5 vs 3.1 %, p = 0.03). In multiple regression models, height, weight and LBM SDS were positively associated with BMDTBLH in VPB children. After adjusting for body size in an analysis of covariance, the difference in BMDTBLH between VPB and term-born children was no longer significant (-0.05 vs -0.09, p = 0.656).
Conclusion:
VPB children had a lower BMDTBLH at age 5 years compared to term-born peers under the NICU nutrition protocol in this cohort, albeit within the normal range. The difference could be explained by a lower height and LBM SDS of VPB children compared to term-born peers. These findings suggest that the lower bone mineralization in this VPB cohort might be a result of altered growth rather than anomalous bone mineralization.
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