Population‐based register study of children born in Sweden from 1997 to 2014 showed an increase in rickets during infancy

Högberg, Ulf; Winbo, Jenny; Fellman, Vineta

doi:10.1111/apa.14835

Cited by 14 publications

(8 citation statements)

References 27 publications

(56 reference statements)

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“…Our data are in agreement with those of a meta‐analysis performed by Revuelta et al, who reported that most studies emanating from Europe and North America, published after the year 2000, found higher prevalence of vitamin D deficiency among children with cancer than those published in the 1980s and the 1990s 10 . In line with our results, studies have indicated an increased prevalence of vitamin D deficiency and rickets in the general paediatric population in Northern Europe 20,21 and recognised this as a rising health issue. Possible causes for this trend could be (a) changes in lifestyle, such as less time spent playing outdoors and use of more sun protection due to an increased awareness of the risk of skin cancer, 22 (b) an increasing proportion of children with obesity, 23 (c) changes in the ethnic composition of the Swedish population with an increase in the number of children with dark skin, and (d) changes in Swedish guidelines for vitamin D supplementation 24…”

Section: Discussionsupporting

confidence: 93%

Prevalence of and factors influencing vitamin D deficiency in paediatric patients diagnosed with cancer at northern latitudes

et al. 2021

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Aim To investigate the prevalence of vitamin D deficiency among children with non‐haematological malignancies and to explore possible causes of low vitamin D levels among these patients. Methods We performed a cross‐sectional study of 458 children diagnosed with solid tumours, brain tumours, non‐Hodgkin lymphoma or Hodgkin disease at the University Children's Hospital, Uppsala, Sweden. Serum 25‐hydroxyvitamin D and parathyroid hormone levels were measured in samples taken at the time of cancer diagnosis and related to clinical data. Vitamin D deficiency was defined as a 25‐hydroxyvitamin D level below 50 nmol/L. Results The prevalence rate of vitamin D deficiency among children with non‐haematological malignancies was 41%. There was no association between sex or diagnosis and vitamin D status. Vitamin D deficiency was more common among school children than preschool children (51% vs. 24%). Older age, season outside summer, and a more recent calendar year were significant predictors of lower 25‐hydroxyvitamin D. There was a significant, albeit weak, negative correlation between 25‐hydroxyvitamin D and parathyroid hormone. Conclusion Vitamin D deficiency is common among children diagnosed with cancer, particularly among school‐aged children diagnosed outside summer. The prevalence appears to be increasing, underlining the need for adequate replacement of vitamin D in these patients.

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Section: Discussionsupporting

confidence: 93%

Prevalence of and factors influencing vitamin D deficiency in paediatric patients diagnosed with cancer at northern latitudes

et al. 2021

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“…Case series have reported long bone shaft fractures associated with metabolic bone disease of infancy [21]. We found only few shaft fractures with a diagnosis of rickets or vitamin D de ciency, as previously reported for fractures of any type [22].…”

Section: Discussionsupporting

confidence: 73%

The Epidemiology of Infant Shaft Fractures of Femur or Humerus by Incidence, Birth, Accidents, and Other Causes

Iversen

Thiblin

Högberg

2020

Preprint

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Background: Knowledge of femur and humerus shaft fractures during infancy is scarce. The purpose of this population-based registry study was to analyze both birth-related femur and humerus shaft fractures and those diagnosed later in infancy, as regards incidence, perinatal characteristics, other diagnoses, and reported accidents.Methods: Children born in 1997–2014, diagnosed with a femur or humerus shaft fracture before age 1 year, were identified in the Swedish Health Registries. Rate of birth fractures were estimated by combining femur and humerus shaft fractures coded as birth-related with femur and humerus shaft fractures diagnosed during day 1-7 without registered trauma, abuse, or bone fragility disorders. Incidence was computed by comparing infants with femur or humerus shaft fractures to the total at-risk population. Results: The incidence for birth-related femur shaft fractures was 0.024‰ (n=45) and that for birth-related humerus shaft fractures was 0.101‰ (n=188). The incidence was 0.154‰ for later femur shaft fractures (n=287) and 0.073‰ for later humerus shaft fractures (n=142). Birth-related femur shaft fracture was associated with preterm, multiple birth, breech, cesarean, and small-for-gestational age, while humerus shaft fracture was associated with preterm, multiple birth, birth weight > 4,000 g, and shoulder dystocia. A bone fragility diagnosis was recorded in 5% of those with birth-related or later femur shaft fractures. Among infants with birth-related humerus shaft fractures, 1% had a bone fragility diagnosis; the figure for later fractures was 6%. Maltreatment diagnosis was associated with both fracture types, especially among those aged < 6 months, where approximately 20% and 14% of cases, respectively, were associated with abuse. Fall accidents were reported in 73% and 56% among those with later femur and humerus shaft fractures, respectively. Conclusion: This study provides data on epidemiology, birth, parental characteristics, and reported accidents in relation to femur and humerus shaft fractures during infancy. Few children had a bone fragility diagnosis. Fall accidents were the main contributor to femur or humerus shaft fracture during infancy; however, the proportion of fractures attributed to maltreatment was high in children under 6 months.

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“…Infants that were entered in the National Patient Register (NPR), but without birth-related or other fractures during the neonatal period served as controls as previously described. 18…”

Section: Controlsmentioning

confidence: 99%

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

et al. 2020

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Aim Specific birth‐related fractures have been studied; underestimates might be a problem. We aimed to assess all fractures diagnosed as birth‐related as well as other neonatal fractures. Methods A population‐based study on all infants born in Sweden 1997‐2014; data were retrieved from the Swedish Health Registers (10th version of International Classification of Diseases. Outcome measures were birth‐related fractures (ICD‐10 P‐codes) and other neonatal fractures (ICD‐10 S‐codes). Results The overall fracture incidence was 2.9 per 1000 live birth (N = 5336); 92.6% had P‐codes and 7.4% (S‐codes). Some birth‐related fractures were diagnosed beyond the neonatal period. Other neonatal fractures could have been birth‐related. Clavicle fracture (88.8%) was associated with adverse maternal and infant anthropometrics and birth complications. The few neonates with rib fractures all had concomitant clavicle fracture. For skull fractures, a minor part was birth‐related and most were associated with accidents. Half of the long bone fractures were associated with accidents. Birth‐related femur fractures were associated with bone fragility risk factors. Five infants with abuse diagnoses had fractures: skull (4), long bone (2) and rib (1). Conclusion Birth‐related and other neonatal fractures are rarely diagnosed. Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures.

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Population‐based register study of children born in Sweden from 1997 to 2014 showed an increase in rickets during infancy

Abstract: Aim: This population-based study assessed the incidence of rickets in infants up to age of one born in Sweden from 1997 to 2014. We also examined maternal and perinatal factors and co-morbidity.

Cited by 14 publications

References 27 publications

Prevalence of and factors influencing vitamin D deficiency in paediatric patients diagnosed with cancer at northern latitudes

Prevalence of and factors influencing vitamin D deficiency in paediatric patients diagnosed with cancer at northern latitudes

The Epidemiology of Infant Shaft Fractures of Femur or Humerus by Incidence, Birth, Accidents, and Other Causes

Difficult birth is the main contributor to birth‐related fracture and accidents to other neonatal fractures

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