Relationship of Tibial Speed of Sound and Lower Limb Length to Nutrient Intake in Preterm Infants

Overview

Journal Arch Dis Child Fetal Neonatal Ed

Specialties Gynecology & Obstetrics
Pediatrics

Date 2007 Mar 21

PMID 17369280

Citations 11

Authors

J Mercy

B Dillon

J Morris

A J Emmerson

M Z Mughal

Affiliations

Soon will be listed here.

Abstract

Background: Metabolic bone disease of prematurity is characterised by impaired postnatal mineralisation of the rapidly growing infant skeleton.

Objective: To longitudinally evaluate postnatal changes in tibial speed of sound (tSOS; which reflects cortical thickness and bone mineral density) and lower limb length (LLL; a measure of tibial growth) in very low birthweight preterm infants receiving contemporary neonatal care.

Methods: tSOS and LLL were measured using a quantitative ultrasound device and an electronic neonatal knemometer, respectively, in the same limb, weekly, for a median period of four weeks (3-16 weeks) in 84 preterm infants (median gestation 26.8 weeks (range 23-35.2 weeks) and median birth weight 869.5 g (range 418-1481 g)).

Results: Initial tSOS and LLL were correlated with gestation (r = 0.42, p<0.001; r = 0.76, p<0.001, respectively) and birth weight (r = 0.23, p = 0.038; r = 0.93, p<0.001, respectively). Postnatally, tSOS decreased (r = -0.15, p = 0.011) whereas LLL increased (r = 0.96, p<0.001) with age. The rate of postnatal change in LLL, but not in tSOS, was positively influenced by intake of calcium (p = 0.03), phosphorus (p = 0.01) and vitamin D (p = 0.03).

Conclusions: The postnatal decline in tSOS, which is probably due to cortical thinning secondary to endocortical bone loss, and increase in LLL provide new insight into the development of long bones in preterm infants.

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References

Njeh C, Hans D, Wu C, Kantorovich E, SISTER M, Fuerst T . An in vitro investigation of the dependence on sample thickness of the speed of sound along the specimen. Med Eng Phys. 2000; 21(9):651-9. DOI: 10.1016/s1350-4533(99)00090-9. View

Specker B . Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density. J Bone Miner Res. 1996; 11(10):1539-44. DOI: 10.1002/jbmr.5650111022. View

Koo W, Hockman E . Physiologic predictors of lumbar spine bone mass in neonates. Pediatr Res. 2000; 48(4):485-9. DOI: 10.1203/00006450-200010000-00011. View

Moyer-Mileur L, Brunstetter V, McNaught T, Gill G, Chan G . Daily physical activity program increases bone mineralization and growth in preterm very low birth weight infants. Pediatrics. 2000; 106(5):1088-92. DOI: 10.1542/peds.106.5.1088. View

Prevrhal S, Fuerst T, Fan B, Njeh C, Hans D, Uffmann M . Quantitative ultrasound of the tibia depends on both cortical density and thickness. Osteoporos Int. 2001; 12(1):28-34. DOI: 10.1007/s001980170154. View

Avila-Diaz M, Amato D . Increments in whole body bone mineral content associated with weight and length in pre-term and full-term infants during the first 6 months of life. Arch Med Res. 2001; 32(4):288-92. DOI: 10.1016/s0188-4409(01)00291-0. View

Rauch F, Schoenau E . The developing bone: slave or master of its cells and molecules?. Pediatr Res. 2001; 50(3):309-14. DOI: 10.1203/00006450-200109000-00003. View

Nemet D, Dolfin T, Wolach B, Eliakim A . Quantitative ultrasound measurements of bone speed of sound in premature infants. Eur J Pediatr. 2002; 160(12):736-40. DOI: 10.1007/s004310100849. View

Weiler H, Paes B, Shah J, Atkinson S . Longitudinal assessment of growth and bone mineral accretion in prematurely born infants treated for chronic lung disease with dexamethasone. Early Hum Dev. 1997; 47(3):271-86. DOI: 10.1016/s0378-3782(96)01783-5. View

10.

Cole T, Freeman J, Preece M . British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Stat Med. 1998; 17(4):407-29. View

11.

Kurjak A, Carrera J, Medic M, Azumendi G, Andonotopo W, Stanojevic M . The antenatal development of fetal behavioral patterns assessed by four-dimensional sonography. J Matern Fetal Neonatal Med. 2005; 17(6):401-16. DOI: 10.1080/14767050400029657. View

12.

McDevitt H, Tomlinson C, White M, Ahmed S . Quantitative ultrasound assessment of bone in preterm and term neonates. Arch Dis Child Fetal Neonatal Ed. 2005; 90(4):F341-2. PMC: 1721918. DOI: 10.1136/adc.2004.065276. View

13.

Littner Y, Mandel D, Mimouni F, Dollberg S . Bone ultrasound velocity of infants born small for gestational age. J Pediatr Endocrinol Metab. 2005; 18(8):793-7. DOI: 10.1515/jpem.2005.18.8.793. View

14.

Rauch F, Schoenau E . Skeletal development in premature infants: a review of bone physiology beyond nutritional aspects. Arch Dis Child Fetal Neonatal Ed. 2002; 86(2):F82-5. PMC: 1721373. DOI: 10.1136/fn.86.2.f82. View

15.

Chitty L, Altman D . Charts of fetal size: limb bones. BJOG. 2002; 109(8):919-29. DOI: 10.1111/j.1471-0528.2002.01022.x. View

16.

Eliakim A, Nemet D, Friedland O, Dolfin T, Regev R . Spontaneous activity in premature infants affects bone strength. J Perinatol. 2002; 22(8):650-2. DOI: 10.1038/sj.jp.7210820. View

17.

Miller M . The bone disease of preterm birth: a biomechanical perspective. Pediatr Res. 2003; 53(1):10-5. DOI: 10.1203/00006450-200301000-00005. View

18.

Iuliano-Burns S, Saxon L, Naughton G, Gibbons K, Bass S . Regional specificity of exercise and calcium during skeletal growth in girls: a randomized controlled trial. J Bone Miner Res. 2003; 18(1):156-62. DOI: 10.1359/jbmr.2003.18.1.156. View

19.

Specker B, Binkley T . Randomized trial of physical activity and calcium supplementation on bone mineral content in 3- to 5-year-old children. J Bone Miner Res. 2003; 18(5):885-92. DOI: 10.1359/jbmr.2003.18.5.885. View

20.

Litmanovitz I, Dolfin T, Friedland O, Arnon S, Regev R, Shainkin-Kestenbaum R . Early physical activity intervention prevents decrease of bone strength in very low birth weight infants. Pediatrics. 2003; 112(1 Pt 1):15-9. DOI: 10.1542/peds.112.1.15. View