Kitazawa Shigetaka, Itabashi Kazuo, Umeda You, Inoue Makoto, Nishioka Takashi
Division of Neonatology, Children's Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
Pediatr Int. 2014 Feb;56(1):67-71. doi: 10.1111/ped.12189.
Preterm infants are at risk for metabolic bone disease and suboptimal growth. This study examined the hypothesis that, apart from prematurity, intrauterine growth status (expressed as gestational age-specific birthweight standard deviation score) influences bone mineralization and body composition in early infancy.
In this retrospective study, the groups consisted of preterm small-for-gestational-age (SGA) infants (n = 18; SGA group) and preterm appropriate-for-gestational-age (AGA) infants (n = 24; AGA group). Postnatal bone mineralization was measured at term-adjusted age (postmenstrual age, 37-42 weeks). Bone mineral content (BMC) and body composition were determined on dual-energy X-ray absorptiometry of the whole body.
BMC and lean mass were significantly lower in the SGA group than in the AGA group at term-adjusted age (37-42 weeks postmenstrual age). Stepwise regression analysis identified weight at examination as the most significant factor, accounting for 51% of the variance in BMC.
Bodyweight at term-adjusted age, rather than intrauterine growth, may affect postnatal bone mineralization in preterm low-birthweight infants. Therefore, promoting an increase in body size might increase postnatal bone mineralization in preterm SGA infants.
早产儿有患代谢性骨病和生长发育欠佳的风险。本研究检验了以下假设:除早产外,宫内生长状况(以特定孕周出生体重标准差评分表示)会影响婴儿早期的骨矿化和身体组成。
在这项回顾性研究中,研究组包括早产小于胎龄儿(SGA)(n = 18;SGA组)和早产适于胎龄儿(AGA)(n = 24;AGA组)。在足月校正年龄(月经龄,37 - 42周)时测量出生后的骨矿化。通过全身双能X线吸收法测定骨矿物质含量(BMC)和身体组成。
在足月校正年龄(月经龄37 - 42周)时,SGA组的BMC和瘦体重显著低于AGA组。逐步回归分析确定检查时的体重是最显著的因素,占BMC变异的51%。
足月校正年龄时的体重而非宫内生长情况,可能会影响早产低体重儿出生后的骨矿化。因此,促进体重增加可能会增加早产SGA婴儿出生后的骨矿化。