Skeletal changes in preterm infants.

Koo, Winston; Gupta, J. M.; Nayanar, V V; Wilkinson, M. C.; Posen, Solomon

doi:10.1136/adc.57.6.447

Cited by 132 publications

(67 citation statements)

References 22 publications

(3 reference statements)

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“…The fact that BMC and appositional bone growth (BW) is decreased in these infants during a time when skeletal growth is occurring, suggests a disorder of formation and/or remodeling of cortical bone. This is supported by many reports of diffusely demineralized bones in routine x-rays of some growing premature infants with metabolic bone disease (9)(10)(11)(12). This disorder may be secondary to a defect in the overall mineralization process ofcortical bone or perhaps due to extensive cortical thinning and remodeling of normally mineralized bone, or a combination thereof.…”

Section: Discussionsupporting

confidence: 57%

Bone Growth with Low Bone Mineral Content in Very Low Birth Weight Premature Infants

Greer

McCormick

1986

Pediatr Res

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MATERIALS AND METHODSand BW at birth. Because ofthe direct relationship between BMC and BW we speculated that the ratio of BMC to BW would be useful in identifying disorders of bone mineral metabolism in low birth weight infants (I).In the present study, we report serial measurements of BMC and BW through the first 10 wk of life in 38 VLBW premature infants. We hypothesized that during this period of active growth in weight and length, BW (a measure ofbone diameter and hence of appositional bone growth in infancy and childhood) would increase secondary to increased matrix formation (2); however, we predicted BMC would decrease or remain unchanged due to insufficient mineral intake compared to that necessary to achieve the intrauterine rate of bone mineralization (l). Following entry into the study, 15 of 38 infants developed BPD and we hypothesized that as a group they could be distinguished from the 23 infants without BPD because of the high association between BPD and metabolic bone disease (3). We anticipated that the ratio of BMC to BW would be lower in the BPD group compared to controls.Population. Thirty-eight VLBW infants (birth weight < 1300 g, gestational age <32 wk) were recruited for this study during the 1st wk of life, after obtaining parental informed consent. Thirty-five infants were white and three infants were black. All infants were appropriate for gestational age. Gestational age was determined from the history of the last menstrual period and corroborated by the Ballard examination for those infants greater than 27 wk gestational age (4). For those infants less than or equal to 27 wk gestation, fetal ultrasound measurements were used as the second corroborator ofgestational age, when available from the department of obstetrics. If there was more than a 2-wk discrepancy between the two determinations of gestational age, the infant was excluded from the study. All infants were admitted to the neonatal intensive care unit at Madison General Hospital and all were free from major congenital malformations.Of these 38 infants, 15 were diagnosed subsequently as having BPD. All infants with BPD had the initial diagnosis of the respiratory distress syndrome, required supplemental oxygen for a minimum of 30 days, and had a chest x-ray diagnosis of BPD (hyperexpansion, interstitial densities, focal emphysema) (5). For purposes of comparison, the remaining 23 infants were designated as controls.Photon absorptiometry. BMC and bone width were measured by a photon absorptiometric system (Lunar Radiation Inc., Madison, WI) in which a collimated 2 mm diameter photon beam from a low activity [ 125 1] "spent source" (20-50 mCi) was passed beneath the one-third distal radius (shaft) of the left forearm. The system has been previously described in detail (1). Measurements of BMC and bone width were made within the 1st wk of life and subsequently at biweekly intervals. Accuracy, precision, and reproducibility of this system used by us in newborn infants have been published (1). Immediate reproducibility 925 Abbrevi...

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Section: Discussionsupporting

confidence: 57%

Bone Growth with Low Bone Mineral Content in Very Low Birth Weight Premature Infants

Greer

McCormick

1986

Pediatr Res

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“…Radiologic abnormalities were generally noted in the second month postnatally; improvement in radiologic signs was generally observed at the age of 6 mo. Radiologic abnormalities were grade 1 or 2 on the Koo score (13) (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Influence of Genetic Polymorphisms on Bone Disease of Preterm Infants

Funke

Morava

Czakó³

et al. 2006

Pediatr Res

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Bone disease is an important complication among very low birth weight (VLBW, Ͻ1500 g) infants. In adults, osteoporosis is associated with polymorphisms of vitamin D receptor (VDR), estrogen receptor (ER), and collagen I␣1 (COLIA1) genes. However, limited information is available regarding the role of these polymorphisms in bone disease in premature infants. We have investigated the possible association between bone disease and the allelic polymorphisms of these three genes in 65 VLBW infants. Twenty infants (30.8%) were diagnosed with bone disease based on high activity of bone formation (serum alkaline phosphatase and osteocalcin), bone resorption (urinary excretion of calcium and pyridinium crosslink) markers, and positive radiologic signs.

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“…Comments on radiographic findings were made by a radiologist who was blinded to laboratory findings. The scoring method of Koo et al 17 …”

Section: Methodsmentioning

confidence: 99%

Biochemical Bone Markers for Early Detection of Osteopaenia of Prematurity

Jahan¹,

Mannan²,

Dey³

et al. 2017

Bangladesh Med Res Counc Bull

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Osteopenia of prematurity (OOP) imposes the risk of fractures and growth failure to premature infants. Studies have investigated the validity of biochemical markers of osteopenia but till date it is not established. So, this study was intended to examine the diagnostic performance of biochemical markers in early detection of osteopenia of prematurity. This prospective study was conducted in the Neonatal Intensive Care Unit (NICU), Department of Neonatology, Bangabandhu Sheikh Mujib Medical University during June 2013 to February 2014. A total of 100 premature infants with gestational age ≤ 34 weeks were consecutively included over 9 months period. Serum alkaline phosphatase, serum calcium and serum inorganic phosphates were measured from 1 week of chronological age until corrected term age. At corrected term age, radiologic examination was done for the assessment of osteopenia. Of the enrolled infants, 36/78 (46%) developed radiological evidence of osteopenia. Serum inorganic phosphate level was significantly less in osteopenic infants than non-osteopenic infants throughout first two months of life (p <0.001). The area under ROC curve for serum inorganic phosphate was 85% (p = 0.001). If the cut off value of serum inorganic phosphate was set at 3.6 mg/dl, then a sensitivity of 86% and a specificity of 49% were obtained. Low serum inorganic phosphate at 3 weeks of life can be used as a marker for early detection of osteopenia of prematurity.

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Skeletal changes in preterm infants.

Cited by 132 publications

References 22 publications

Bone Growth with Low Bone Mineral Content in Very Low Birth Weight Premature Infants

Bone Growth with Low Bone Mineral Content in Very Low Birth Weight Premature Infants

Influence of Genetic Polymorphisms on Bone Disease of Preterm Infants

Biochemical Bone Markers for Early Detection of Osteopaenia of Prematurity

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