Division of Neonatology, Department of Pediatrics, Amsterdam UMC, Location VU University Medical Center, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Location Academic Medical Center and University of Amsterdam, Amsterdam, The Netherlands.
Eur J Pediatr. 2021 Sep;180(9):3009-3017. doi: 10.1007/s00431-021-04081-4. Epub 2021 Apr 22.
In this study, we aimed to (a) evaluate postnatal changes in bone development in relation to growth and (b) to determine factors associated with bone development, from birth to 24 months of corrected age. The metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) were used to evaluate bone development in 98 preterm infants, during hospitalization and follow-up. The mcSOS and mcBTT values not only declined in the first 6 weeks of hospitalization but also during follow-up. The mcSOS reached its lowest point at 12 months (β=-34.64), while the mcBTT reached a plateau between 12 and 24 months (β=0.06). Univariable analysis showed that gender (p=0.28), time (p<0.001), and growth parameters (p<0.001) were significant negative associated factors with mcSOS, whereas with mcBTT, time (p=0.009), length (p=0.063), length standard deviation scores (SDS) (p=0.027), head circumference (p=0.005), and head circumference SDS (p=0.007) were significant positive. The multivariable model revealed that time (β= -3.364, p=<0.001), weight (β=-0.007, p<0.001) and length (β=1.163, p<0.001) for mcSOS and length (β=-0.021, p<0.001), and length SDS (β= 0.066, p<0.001) and head circumference (β=0.049, p<0.001) for mcBTT remained highly significant associated factors.Conclusion: The most important finding is that mcSOS decreased and the mcBTT reached a plateau to 24 months. In both mcSOS and mcBTT, the growth parameters were significant factors.Clinical Trial Registration: N/A What is known: • Metabolic bone disease is one of the possible long term adverse outcomes after preterm birth. • Metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) decline in the early postnatal period. What is new: • During follow-up, mcSOS further decreased and reached its lowest point at 12 months, while the mcBTT reached a plateau up to 24 months. • Postnatal nutrition in relation to comorbidity does not meet the optimal mineralization rate of the developing preterm bone.
在这项研究中，我们旨在：（a）评估与生长相关的骨骼发育的产后变化；（b）确定从出生到 24 个月校正年龄期间与骨骼发育相关的因素。使用掌骨声速（mcSOS）和掌骨骨传输时间（mcBTT）评估 98 名早产儿在住院期间和随访期间的骨骼发育情况。mcSOS 和 mcBTT 值不仅在住院的前 6 周下降，而且在随访期间也下降。mcSOS 在 12 个月时达到最低点（β=-34.64），而 mcBTT 在 12 至 24 个月之间达到平台期（β=0.06）。单变量分析表明，性别（p=0.28）、时间（p<0.001）和生长参数（p<0.001）与 mcSOS 显著负相关，而与 mcBTT 相关的是时间（p=0.009）、长度（p=0.063）、长度标准差评分（SDS）（p=0.027）、头围（p=0.005）和头围 SDS（p=0.007）。多变量模型显示时间（β=-3.364，p<0.001）、体重（β=-0.007，p<0.001）和长度（β=1.163，p<0.001）与 mcSOS 以及长度（β=-0.021，p<0.001）和长度 SDS（β=0.066，p<0.001）和头围（β=0.049，p<0.001）与 mcBTT 仍然是高度显著相关的因素。结论：最重要的发现是，mcSOS 下降，mcBTT 到 24 个月时达到平台期。在 mcSOS 和 mcBTT 中，生长参数都是重要的因素。临床试验注册：无 已知内容：•代谢性骨病是早产儿出生后可能出现的长期不良后果之一。•掌骨声速（mcSOS）和掌骨骨传输时间（mcBTT）在新生儿期后下降。 新内容：•在随访期间，mcSOS 进一步下降，在 12 个月时达到最低点，而 mcBTT 则在 24 个月时达到平台期。•与并发症相关的产后营养无法满足发育中早产儿骨骼的最佳矿化率。
