Article Text

other Versions

PDF
The relationship of tibial speed of sound and lower limb length to nutrient intake in preterm infants.
  1. J Mercy (judymercy{at}onetel.com)
  1. Neonatal Medicine, St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom
    1. B Dillon (bernice.dillon{at}manchester.ac.uk)
    1. Medical Statistics, South Manchester University Hospitals Trust, Manchester, M23 9LT, United Kingdom
      1. J Morris (julie.morris{at}manchester.ac.uk)
      1. Medical Statistics, South Manchester University Hospitals Trust, Manchester, M23 9LT, United Kingdom
        1. A J Emmerson (anthony.emmerson{at}cmmc.nhs.uk)
        1. Neonatal Medicine, St. Mary’s Hospital for Women and Children, Manchester M13 0JH, United Kingdom
          1. M Zulf Mughal (zulf.mughal{at}cmmc.nhs.uk)
          1. St Mary's Hospital for Women and Children, United Kingdom

            Abstract

            Background:Metabolic bone disease of prematurity (MBDP) 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 birth weight preterm infants receiving contemporary neonatal care.

            Methods:tSOS was measured, using a quantitative ultrasound device and LLL, using an electronic neonatal knemometer and in the same limb, weekly, for a median period of 4 weeks (3-16 weeks) in 84 preterm infants. The median gestation and birth weight of infants was 26.8 weeks (23-35.2 weeks) and 869.5g (418-1481g) respectively.

            Results:The initial tSOS and LLL were associated with gestation (r=0.42, p<0.001; r=0.76, p<0.001) and birth weight (r=0.23, p=0.038; r=0.93, p<0.001). Postnatally, tSOS decreased (r= -0.15; p=0.011) whereas the LLL increased (r=0.96; p<0.001) with age. The rate of postnatal change in LLL, but not the change 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 likely to be due to cortical thinning secondary to endocortical bone loss, and increase in LLL provides a new insight into long-bone development in preterm infants.

            • knemometry
            • lower limb length
            • metabolic bone disease of prematurity
            • quantitative ultrasound
            • speed of sound

            Statistics from Altmetric.com

            Request permissions

            If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.