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[Roentgenologic determination of maturity in low birthweight infants]
Insights
This study found no statistical difference in epiphyseal center size between preterm, small for gestational age (SGA), and appropriate for gestational age (AGA) infants. Bone age appears more resilient to fetal malnutrition than overall growth in neonates.
Area of Science:
- Neonatalogy
- Pediatric Radiology
- Developmental Biology
Background:
- Low birthweight infants present diverse growth patterns.
- Distinguishing between preterm and small for gestational age (SGA) neonates is clinically important.
- Epiphyseal ossification is a marker of skeletal maturation.
Purpose of the Study:
- To evaluate the utility of epiphyseal center size in differentiating low birthweight infant groups.
- To assess skeletal maturation in preterm, SGA, and appropriate for gestational age (AGA) neonates.
- To investigate the relationship between fetal malnutrition and bone age.
Main Methods:
- X-ray analysis of knee and ankle epiphyseal centers in 121 low birthweight infants.
- Measurement of epiphyseal ossification in distal femur, proximal tibia, talus, and calcaneus.
- Comparison of epiphyseal size across four groups: preterm, SGA, AGA, and Clifford syndrome.
Main Results:
- Epiphyseal centers showed expected growth from 33 to 42 weeks gestation.
- No statistically significant differences in epiphyseal size were found between the preterm, SGA, and AGA groups.
- The method was insufficient to distinguish preterm infants from SGA infants based on epiphyseal size alone.
Conclusions:
- Epiphyseal ossification patterns, as measured by size, do not reliably differentiate preterm from SGA infants in this cohort.
- Bone age may be a more robust indicator of fetal nutritional status than simple mass growth.
- Further research is needed to refine methods for assessing skeletal maturity in low birthweight neonates.
Abstract:
121 infants with low birthweight and a well known gestational age were divided into four groups: preterm infants, small for gestational age (SGA) infants, appropriate for gestational age (AGA) infants and infants with Clifford syndrome. With the 100 mm spot film technique X-rays of the right knee and ancle of the infants were taken and the size of the epiphyseal centers of the distal femur, the proximal tibia, the talus and the calcaneus was measured. The mean organ dose of the leg was only 2 mrad. All epiphyseal centers examined showed an increase from the 33rd to the 42nd week of gestation, which is in good agreement to previous studies. There was no evidence of a statistical difference of epiphyseal size between the four examined groups of neonates of low birthweight. Thus, in the present material with very close mean birthweights of the four groups, we were unable to distinguish preterm born infants from SGA infants with this method alone. This result suggests, that bone age is a more resistant criteria to fetal malnutrition than mass growth.