Factors affecting newborn bone mineral content:<i>in utero</i>effects on newborn bone mineralization

Namgung, Ran; Tsang, Reginald C.

doi:10.1017/s0029665100000070

Cited by 94 publications

(60 citation statements)

References 79 publications

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“…18,19 The present study adds to this knowledge the fact that after accounting for these variables, infant BMC is positively associated with infant vitamin D status. Therefore, larger infants will have greater BMC only if they have adequate vitamin D. The inverse relation between infant BMC and maternal vitamin D concentration observed in the regression analysis, after accounting for infant gestational age, weight and vitamin D status at birth, is new and difficult to explain.…”

Section: Discussionmentioning

confidence: 66%

Vitamin D deficiency and whole-body and femur bone mass relative to weight in healthy newborns

Weiler

Fitzpatrick‐Wong²,

Veitch³

et al. 2005

Canadian Medical Association Journal

142

100

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Background: Vitamin D is required for normal bone growth and mineralization. We sought to determine whether vitamin D deficiency at birth is associated with bone mineral content (BMC) of Canadian infants. Methods: We measured plasma 25-hydroxyvitamin D [25(OH)D]as an indicator of vitamin D status in 50 healthy mothers and their newborn term infants. In the infants, anthropometry and lumbar, femur and whole-body BMC were measured within 15 days of delivery. Mothers completed a 24-hour recall and 3-day food and supplement record. We categorized the vitamin D status of mothers and infants as deficient or adequate and then compared infant bone mass in these groups using nonpaired t tests. Maternal and infant variables known to be related to bone mass were tested for their relation to BMC using backward stepwise regression analysis. Results: Twenty-three (46%) of the mothers and 18 (36%) of the infants had a plasma 25(OH)D concentration consistent with deficiency. Infants who were vitamin D deficient were larger at birth and follow-up. Absolute lumbar spine, femur and whole-body BMC were not different between infants with adequate vitamin D and those who were deficient, despite larger body size in the latter group. In the regression analysis, higher whole-body BMC was associated with greater gestational age and weight at birth as well as higher infant plasma 25(OH)D. Conclusion: A high rate of vitamin D deficiency was observed among women and their newborn infants. Among infants, vitamin D deficiency was associated with greater weight and length but lower bone mass relative to body weight. Whether a return to normal vitamin D status, achieved through supplements or fortified infant formula, can reset the trajectory for acquisition of BMC requires investigation.

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Section: Discussionmentioning

confidence: 66%

Vitamin D deficiency and whole-body and femur bone mass relative to weight in healthy newborns

Weiler

Fitzpatrick‐Wong²,

Veitch³

et al. 2005

Canadian Medical Association Journal

142

100

View full text Add to dashboard Cite

show abstract

“…These findings confirm published data reporting a reduced bone mineral density in SGA compared with AGA infants measured by X-ray absorptiometry and DXA. 37,38 Two studies using tibial speed of sound reported higher QUS values for SGA compared with AGA infants, which might, however, be explained by a soft-tissue effect that none of the working groups corrected for. 16,17 The main cause of osteopenia of prematurity is the postnatally reduced supply of calcium, phosphate and vitamin D. Several studies provide evidence that an increased supply of these substances can improve bone mineral density during the neonatal period as measured by photonabsorption densitometry.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

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Objective: As 80% of intrauterine bone mineralization takes place during the last trimester of pregnancy, preterm infants should be supplemented postnatally with optimal doses of calcium, phosphate and vitamin D. Calcium and phosphate excretion in the urine may be used to monitor individual mineral requirements, but are sometimes difficult to interpret. The objective of this study was to assess the value of quantitative ultrasound (QUS) for the analysis of bone status in neonates.Study Design: All admissions to three independent tertiary neonatal intensive care units were studied. In 172 preterm and term infants with a gestational age between 23 and 42 weeks (mean 33.8 ± 5.0) and a birth weight from 405 to 5130 g (mean 2132±1091 g) bone status was evaluated prospectively by quantitative ultrasound velocity using a standardized protocol. Infants were followed in regular intervals up to their first discharge home. While measurements were conducted in weekly intervals initially (n ¼ 55), 2-week intervals were regarded as sufficient thereafter due to limited changes in QUS values within the shorter period. Infants with a birth weight below 1500 g were followed during outpatient visits until up to 17 months of age.Result: The intra-individual day-to-day reproducibility was 0.62%. QUSvalues from the first week of life correlated significantly with gestational age and birth weight (r ¼ 0.5 and r ¼ 0.6; P<0.001). Small-forgestational-age infants showed lower values for QUS than appropriate-forgestational-age infants allowing for their gestational age. Follow-up measurements correlated positively with age and weight during the week of measurement (r ¼ 0.2 and r ¼ 0.4; P ¼ 0.001). Comparing bone quality at 40 weeks of age in infants born at term versus infants born at 24 to 28 weeks, preterm infants showed significantly lower QUS than term infants (P<.0001).There was a significant correlation of QUS with serum alkaline phosphatase (P ¼ 0.003), the supplementation with calcium, phosphate and vitamin D (P< 0.001 each), as well as risk factors for a reduced bone mineralization. No correlation was found between QUS and calcium or phosphate concentration in serum or urine.Conclusion: QUS is a highly reproducible, easily applicable and radiation-free technique that can be used to monitor bone quality in individual newborns. Further prospective randomized-trials are necessary to evaluate, if therapeutic interventions based on QUS are able to prevent osteopenia of prematurity.

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“…For example, it is possible that altered bone mineralization, which is known to be a consequence of IUGR (39), could have made the ribs more compliant. Whatever the causes of the increase in C W , the effects were still evident at 8 wk and likely would have persisted beyond this age.…”

Section: Discussionmentioning

confidence: 99%

Compromised Respiratory Function in Postnatal Lambs after Placental Insufficiency and Intrauterine Growth Restriction

et al. 2001

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Epidemiologic studies have shown persistent effects of low birth weight on respiratory function and lung health, but underlying mechanisms are not understood. Our aim was to determine the effects of intrauterine growth restriction (IUGR), a major cause of low birth weight, on postnatal respiratory function. IUGR was induced by umbilico-placental embolization during late gestation in chronically catheterized sheep. Umbilicoplacental embolization was performed between 120 d of gestation and term (~146 d) during which fetuses were hypoxemic and hypoglycemic relative to controls. Umbilico-placental embolization led to a 48% reduction in birth weight compared with controls, and throughout the postnatal study period IUGR lambs (n ϭ 8) remained lighter than controls (n ϭ 8). Respiratory function was repeatedly studied in lambs for 8 wk after birth; during this period, IUGR lambs were mildly hypoxemic and tended to be hypercapnic compared with controls. In IUGR lambs, relative to controls, O 2 consumption (mL/min/kg) and minute ventilation (mL/kg) were increased and pulmonary diffusing capacity (adjusted for functional residual capacity) was decreased. Functional residual capacity, measured by helium dilution, and total lung capacity (measured at 30 cm H 2 O) were smaller in IUGR lambs than in controls. When adjusted for functional residual capacity, static lung compliance was reduced and chest wall compliance was increased in IUGR lambs. Restricted fetal growth, resulting in low birth weight, has been associated with altered lung development and impaired respiratory function after birth. Recent studies of neonates and infants who have been growth restricted in utero indicate that they have an increased risk of mortality and morbidity (1), including respiratory distress (2, 3). Respiratory compromise may persist during postnatal development as it has been shown that children with evidence of growth restriction in utero have reduced forced expiratory flow rates (4, 5) indicative of impaired airway function. In addition, adults who were of low birth weight and, therefore, likely to have been growth restricted in utero, have reduced expiratory flow rates and an increased risk of respiratory morbidity and mortality (6, 7). Thus, a number of epidemiologic studies suggest that pulmonary gas exchange and airway function after birth may be affected by IUGR.Placental insufficiency and IUGR are common causes of low birth weight, and are associated with pregnancy-induced hypertension, maternal tobacco smoking, and placental pathology (8, 9). Fetuses identified as being growth restricted have been found to be hypoxemic, hypoglycemic, and to have elevated

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Factors affecting newborn bone mineral content:in uteroeffects on newborn bone mineralization

Cited by 94 publications

References 79 publications

Vitamin D deficiency and whole-body and femur bone mass relative to weight in healthy newborns

Vitamin D deficiency and whole-body and femur bone mass relative to weight in healthy newborns

Ultrasound for the assessment of bone quality in preterm and term infants

Compromised Respiratory Function in Postnatal Lambs after Placental Insufficiency and Intrauterine Growth Restriction

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