Effects of prematurity, intrauterine growth status, and early dexamethasone treatment on postnatal bone mineralisation
S Kurla, K Heinonena, E Länsimiesb
a Department of
Paediatrics, Kuopio University Hospital, PO Box 1777, 70211 Kuopio,
Finland, b Department of Clinical Physiology
Correspondence to: Dr Kurl email: skurl{at}messi.uku.fi
Accepted 4
February
AIM
To examine the
hypothesis that, apart from prematurity, intrauterine growth status
(expressed as gestational age specific birth weight standard deviation
scores), neonatal factors, and duration of dexamethasone treatment
influence bone mineralisation in early infancy.
METHODSIn this
prospective study, groups consisted of 15 preterm small for gestational
age infants (SGA group) and 43 preterm appropriate for gestational age
infants (AGA group). A reference group contained 17 term infants. Body
size is known to affect bone mineral content (BMC), therefore postnatal
bone mineralisation was measured when the study infants and controls
had attained a similar body size. Bone mineral density (BMD) and BMC
were determined by dual energy x ray
absorptiometer of the lumbar spine
(L2-L4).
RESULTSBoth preterm
groups had significantly lower BMC and BMD than the weight matched term
reference group, but no difference was found in BMC and BMD between
preterm SGA and AGA infants. In stepwise regression analysis, bone
area, duration of dexamethasone treatment, weight at examination, and
weight gain per week were the most significant factors, explaining 54%
of the variance of the BMC values.
CONCLUSIONIn
particular, weight at examination, prematurity, and possibly
dexamethasone treatment, but not intrauterine growth status, affect postnatal bone mineralisation.
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Key messages
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Keywords: preterm infants; intrauterine growth status; bone mineral density; bone mineral content; dual energy absorptiometry; dexamethasone
© 2000 by Archives of Disease in Childhood
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