Centre for Arthritis and Musculoskeletal Health, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
J Anat. 2019 Oct;235(4):749-756. doi: 10.1111/joa.13024. Epub 2019 Jun 20.
The intrauterine environment is known to influence foetal development and future health. Low birthweight has been linked to smaller vertebral canals in children and decreased adulthood spine bone mineral content. Perinatal factors affecting lumbar spine curvature have not yet been considered but could be important for adult spinal health, as lumbar movement during lifting, a risk factor for backpain, is associated with lordosis. To investigate this, lumbar spine magnetic resonance images at age 10 years and perinatal and maternal data (birthweight, placental weight, gestation length, crown-heel length, maternal age, height, weight and smoking status) from 161 children born in Aberdeen in 1988-1989 were acquired. Statistical shape modelling, using principal component analysis, quantified variations in lumbar spine shape and resulting modes of variation were assessed in combination with perinatal data using correlations and analyses of covariance, adjusted for potential confounders. Spine modes 1-3 (SM1-SM3) captured 75% of the variation in lumbar spine shape. The first and third modes described the total amount (SM1) and evenness of curvature distribution (SM3). SM2 accounted for variations in antero-posterior vertebral diameter relative to vertebral height, increasing positive scores representing a larger relative diameter. Adjusting for gestation length and sex, SM2 positively correlated with birthweight (r = 0.25, P < 0.01), placental weight (r = 0.20, P = 0.04), crown-heel length (r = 0.36, P < 0.001) and maternal weight (r = 0.19, P = 0.04), and negatively with maternal age (r = -0.22, P = 0.02). SM2 scores were lower in girls (P < 0.001) and in the low birthweight group (P = 0.02). There were no significant differences in SM1 and SM3 scores between birthweight groups, boys and girls or children of smokers (31%) and non-smokers (69%). In conclusion, some perinatal factors were associated with vertebral body morphology but had little effect on lumbar curvature.
子宫内环境已知会影响胎儿发育和未来健康。低出生体重与儿童较小的椎管和成年后脊柱骨矿物质含量减少有关。影响腰椎曲度的围产期因素尚未被考虑,但对于成人脊柱健康可能很重要,因为在举重过程中,腰椎运动与腰痛的一个危险因素——腰椎前凸有关。为了研究这一点,研究人员获取了 1988 年至 1989 年在阿伯丁出生的 161 名 10 岁儿童的腰椎磁共振图像和围产期及产妇数据(出生体重、胎盘重量、妊娠长度、头臀长、产妇年龄、身高、体重和吸烟状况)。使用主成分分析的统计形状建模量化了腰椎形状的变化,并用相关分析和协方差分析评估了由此产生的变化模式,这些分析结合了围产期数据,调整了潜在的混杂因素。脊柱模式 1-3(SM1-SM3)捕获了腰椎形状变化的 75%。第一和第三模式描述了曲率分布的总量(SM1)和均匀性(SM3)。SM2 代表了相对于椎体高度的前后椎体直径的变化,增加的正值表示相对直径较大。在调整妊娠长度和性别后,SM2 与出生体重(r=0.25,P<0.01)、胎盘重量(r=0.20,P=0.04)、头臀长(r=0.36,P<0.001)和产妇体重(r=0.19,P=0.04)呈正相关,与产妇年龄(r=-0.22,P=0.02)呈负相关。SM2 评分在女孩中较低(P<0.001),在低出生体重组中较低(P=0.02)。在出生体重组、男孩和女孩或吸烟者(31%)和非吸烟者(69%)之间,SM1 和 SM3 评分没有显著差异。总之,一些围产期因素与椎体形态有关,但对腰椎曲度影响很小。