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Longitudinal changes in bone quantitative ultrasound measurements in healthy pre-school children: Maternal and child
Sandra Cerar1, Evgen Benedik2, Tatjana Robič Pikel3
1Devision of Neonatology, University Children's Hospital, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Vrazov trg 1, 1000, Ljubljana, Slovenia.
Insights
Maternal vitamin D deficiency and thyroid issues during pregnancy, along with childhood BMI, are linked to lower bone density in preschoolers. These factors impact bone speed of sound (SOS) development from infancy through age seven.
Area of Science:
- Pediatrics
- Orthopedics
- Endocrinology
Background:
- Maternal health and environmental factors during early life significantly influence offspring bone development.
- Understanding these influences is crucial for identifying potential interventions to promote optimal bone health from infancy through preschool years.
Purpose of the Study:
- To investigate the impact of maternal exposures during pregnancy and childhood environmental factors on bone health in preschool-aged offspring.
- To identify specific maternal and child factors associated with bone mineral density in early childhood.
Main Methods:
- A prospective cohort study monitored 146 Slovenian mother-offspring pairs from birth to 7 years.
- Maternal data included health status, anthropometry, 25-hydroxyvitamin D (25(OH)D), adiponectin, diet, and bone ultrasound (SOS).
- Offspring bone SOS was measured at birth, 1, 3, 12 months, and 7 years; diet was assessed at 7 years.
Main Results:
- Bone speed of sound (SOS) values showed significant changes over time, decreasing at 1-3 months and increasing by 12 months and 7 years.
- Low maternal 25(OH)D concentrations and maternal thyroid dysfunction were associated with lower offspring SOS at birth.
- Childhood body mass index (BMI) Z-score correlated with bone SOS values throughout the study period.
Conclusions:
- The study identified preschool children with suboptimal bone mineral density.
- Low maternal 25(OH)D, maternal thyroid dysfunction, and the child's BMI Z-score are risk factors for reduced bone SOS.
- Findings may not be generalizable due to the healthier lifestyle of the study cohort.
Aim:
To evaluate the existing evidence on how maternal exposures during pregnancy and environmental factors during childhood influence bone health in offspring during the preschool years.
Methods:
In this prospective cohort study, 146 Slovenian pregnant women and their offspring from birth to 7 years of age were monitored. The pregnant women's health status, anthropometry, serum 25-hydroxyvitamin D and adiponectin concentrations, dietary assessments, and quantitative ultrasound measurements of tibial bone speed of sound (SOS) value were recorded. The children's clinical status, anthropometric measurements, and tibial bone SOS value were assessed at birth, 1, 3 and 12 months, and 7 years of age, with diet assessed at 7 years.
Results:
The longitudinal quantitative ultrasound measurements of bones revealed a significant effect of time on SOS measurements (F = 232.4, p < 0.001): SOS values were significantly lower at 1 and 3 months than at birth, while at 12 months and 7 years they were significantly higher than at birth, and 1 and 3 months. Infants with normal SOS showed a greater decline at 3 months. Low maternal 25(OH)D concentrations (r = -0.32; p = 0.01) and thyroid dysfunction (p < 0.05) were associated with lower SOS values at birth. Additionally, body mass index Z-score during the preschool period was associated with bone SOS values (at 1, 3 and 12 months and 7 years of age: p = 0.04; P = 0.01; p = 0.02, and p = 0.04, respectively).
Conclusion:
Otherwise healthy preschool children with non-optimal bone mineral density were identified. Low maternal 25(OH)D, thyroid dysfunction, and the child's BMI Z-score were associated with lower SOS values. Due to the inclusion of participants with a healthier lifestyle, the data is not generalisable.
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