Dynamics of changes in the velocity of ultrasound propagation in the bone tissue of premature children according to the data of ultrasound densitometry

Authors

DOI:

https://doi.org/10.14739/2310-1237.2023.2.279312

Keywords:

neonatal prematurity, children, ultrasonography, densitometry

Abstract

All premature babies lack the intrauterine phase of active mineralization of the bones, osteogenesis changes, speed of ultrasound propagation in bone tissue changes.

Aim. The purpose of the article was to determine osteopenia in premature babies (PB) based on ultrasound densitometry at birth and during the period of intensive care.

Materials and methods. 70 premature babies and 20 full-term newborns were studied. The authors determined the bone ultrasound speed (SOS, m/s) and its comparative evaluation (Z-score) with the representative base of the ultrasound sonometer “Sunlight Omnisense 9000” (Israel). SOS was defined as average at Z ≥-1.0 SD, as low – at Z from -1.1 to -2.0 SD, and as significantly low – Z ≤- 2.0 SD.

Results. 54.3 % of PB had osteopenia at birth: low indicators in 28.6 %, significantly low in 25.7 %. Postnatally, an increase in bone tissue deficiency of PB was observed – osteopenia with a low Z was diagnosed in 41.1 %, with a significantly low – in 37.5 % of PB.

Conclusions. The number of PB with osteopenia increased 1.4 times, during the first 4 weeks of life. An increase in bone tissue deficiency was most often (p < 0.05) observed among children (52.0 %) with normal / average Z-score SOS indicators. Z-score SOS indicators in children with osteopenia were stable during the first month of life. The odds ratio of having osteopenia were 3.37 times higher for those born in GA of 33 weeks or less (OR = 3.37; CI 95 % [1.25, 9.09], p < 0.05), and 7.50 times higher odds of having significantly low Z-scores (OR = 7.50; CI 95 % [1.60, 34.59], p < 0.05), ), and 8.15 times higher odds of having significantly low Z-scores after 1 month of life (OR = 8.15; CI 95 % [2.23; 29.70], р < 0.05), than in children with greater GA. Indicators of physical development of premature newborns do not allow assessing the state of bone mineral velocity and require dynamic ultrasonic densitometry, despite the presence of correlations of SOS with indicators of the mass or length of infants depending on the gestational timing of birth.

Author Biographies

A. Yu. Tsymbal, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

PhD student of the Department of Pediatric Diseases

Yu. V. Kotlova, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, Associate Professor of the Department of Pediatric Diseases

References

  1. Wang, J., Zhao, Q., Chen, B., Sun, J., Huang, J., Meng, J., Li, S., Yan, W., Ren, C., & Hao, L. (2022). Risk factors for metabolic bone disease of prematurity: A meta-analysis. PloS one, 17(6), e0269180.https://doi.org/10.1371/journal.pone.0269180
  2. Angelika, D., Ugrasena, I. D. G., Etika, R., Rahardjo, P., Bos, A. F., & Sauer, P. J. J. (2021). The incidence of osteopenia of prematurity in preterm infants without phosphate supplementation: A prospective, observational study: A prospective, observational study. Medicine, 100(18),e25758.https://doi.org/10.1097/MD.0000000000025758
  3. Rehman, M. U., & Narchi, H. (2015). Metabolic bone disease in the preterm infant: Current state and future directions. World journal of methodology, 5(3), 115-121. https://doi.org/10.5662/wjm.v5.i3.115
  4. Stalnaker, K. A., & Poskey, G. A. (2016). Osteopenia of Prematurity: Does Physical Activity Improve Bone Mineralization in Preterm Infants?. Neonatal network : NN, 35(2), 95-104. https://doi.org/10.1891/0730-0832.35.2.95
  5. Torró-Ferrero, G., Fernández-Rego, F. J., & Gómez-Conesa, A. (2021). Physical therapy to prevent osteopenia in preterm infants: A systematic review. Children (Basel, Switzerland), 8(8), 664. https://doi.org/10.3390/children8080664
  6. Ministry of Health of Ukraine. (2022). Unifikovanyi klinichnyi protokol "Parenteralne kharchuvannia novonarodzhenykh ditei" [Unified clinical protocol "Parenteral nutrition of newborn children"]. https://neonatology.org.ua/news/association/2022/04/570
  7. Tong, L., Gopal-Kothandapani, J. S., & Offiah, A. C. (2018). Feasibility of quantitative ultrasonography for the detection of metabolic bone disease in preterm infants - systematic review. Pediatric radiology, 48(11), 1537-1549. https://doi.org/10.1007/s00247-018-4161-5
  8. Viswanathan, S., Khasawneh, W., McNelis, K., Dykstra, C., Amstadt, R., Super, D. M., Groh-Wargo, S., & Kumar, D. (2014). Metabolic bone disease: a continued challenge in extremely low birth weight infants: A continued challenge in extremely low birth weight infants. JPEN. Journal of parenteral and enteral nutrition, 38(8), 982-990. https://doi.org/10.1177/0148607113499590
  9. Nehra, D., Carlson, S. J., Fallon, E. M., Kalish, B., Potemkin, A. K., Gura, K. M., Simpser, E., Compher, C., Puder, M., & American Society for Parenteral and Enteral Nutrition. (2013). A.S.P.E.N. clinical guidelines: nutrition support of neonatal patients at risk for metabolic bone disease: Nutrition support of neonatal patients at risk for metabolic bone disease. JPEN. Journal of parenteral and enteral nutrition, 37(5), 570-598. https://doi.org/10.1177/0148607113487216
  10. Shalof, H., Dimitri, P., Shuweihdi, F., & Offiah, A. C. (2021). "Which skeletal imaging modality is best for assessing bone health in children and young adults compared to DXA? A systematic review and meta-analysis". Bone, 150, 116013. https://doi.org/10.1016/j.bone.2021.116013
  11. Chong, K. H., Poh, B. K., Jamil, N. A., Kamaruddin, N. A., & Deurenberg, P. (2015). Radial quantitative ultrasound and dual energy x-ray absorptiometry: intermethod agreement for bone status assessment in children. BioMed research international, 2015, 232876. https://doi.org/10.1155/2015/232876
  12. ISCD. (2019, June). Official positions 2019 – Pediatric. Skeletal Health Assessment in Children from Infancy to Adolescence. https://iscd.org/wp-content/uploads/2021/09/2019-Official-Positions-Pediatric-1.pdf
  13. Marushko, Yu. V., Volokha, T. I., & Asonov, S. A. (2016). Ultrazvukova densytometriia (aksialne vymiriuvannia) u diahnostytsi osteopenichnoho syndromu u ditei z riznoiu somatychnoiu patolohiieiu [Ultrasound densitometry (axial dimension) in the diagnosis of osteopenia syndromein children with various somatic pathology]. Sovremennaya pediatriya, (1), 54-58. [in Ukrainian].
  14. Sethi, A., Priyadarshi, M., & Agarwal, R. (2020). Mineral and bone physiology in the foetus, preterm and full-term neonates. Seminars in fetal & neonatal medicine, 25(1), 101076. https://doi.org/10.1016/j.siny.2019.101076
  15. Kelly, A., Kovatch, K. J., & Garber, S. J. (2014). Metabolic bone disease screening practices among U.S. neonatologists. Clinical pediatrics, 53(11), 1077-1083. https://doi.org/10.1177/0009922814535661
  16. Fenton, T. R., & Kim, J. H. (2013). A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC pediatrics, 13, 59. https://doi.org/10.1186/1471-2431-13-59
  17. Faienza, M. F., D’Amato, E., Natale, M. P., Grano, M., Chiarito, M., Brunetti, G., & D’Amato, G. (2019). Metabolic bone disease of prematurity: Diagnosis and management. Frontiers in pediatrics, 7. https://doi.org/10.3389/fped.2019.00143
  18. Avila-Alvarez, A., Urisarri, A., Fuentes-Carballal, J., Mandiá, N., Sucasas-Alonso, A., & Couce, M. L. (2020). Metabolic bone disease of prematurity: Risk factors and associated short-term outcomes. Nutrients, 12(12), 3786. https://doi.org/10.3390/nu12123786
  19. Ramot, R., Kachhawa, G., Kulshreshtha, V., Varshney, S., Sankar, M. J., Devasenathipathy, K., Sreenivas, V., & Khadgawat, R. (2019). Bone Mass in Newborns Assessed by DXA - A Systematic Review and Meta-analysis. Indian journal of endocrinology and metabolism, 23(2), 198-205. https://doi.org/10.4103/ijem.IJEM_681_18
  20. Mihatsch, W., Dorronsoro Martín, I., Barrios-Sabador, V., Couce, M. L., Martos-Moreno, G. Á., Argente, J., Quero, J., & Saenz de Pipaon, M. (2021). Bone mineral density, body composition, and metabolic health of very low birth weight infants fed in hospital following current macronutrient recommendations during the first 3 years of life. Nutrients, 13(3), 1005. https://doi.org/10.3390/nu13031005
  21. Körnmann, M. N., Christmann, V., Gradussen, C. J. W., Rodwell, L., Gotthardt, M., Van Goudoever, J. B., & Van Heijst, A. F. J. (2017). Growth and Bone Mineralization of Very Preterm Infants at Term Corrected Age in Relation to Different Nutritional Intakes in the Early Postnatal Period. Nutrients, 9(12), 1318. https://doi.org/10.3390/nu9121318
  22. deLange, A., Maaskant, J. M., &vanWeissenbruch, M. M. (2021). Is quantitative ultrasound a measure for metabolic bone disease in preterm-born infants? A prospective subcohort study. European journal of pediatrics, 180(9), 3009-3017. https://doi.org/10.1007/s00431-021-04081-4
  23. Chen, H.-L., Lee, W.-T., Lee, P.-L., Liu, P.-L., & Yang, R.-C. (2016). Postnatal changes in tibial bone speed of sound of preterm and term infants during infancy. PloS One, 11(11), e0166434. https://doi.org/10.1371/journal.pone.0166434
  24. Zhao, Z., Ding, M., Hu, Z., Dai, Q., Satija, A., Zhou, A., Xu, Y., Zhang, X., Hu, F. B., & Xu, H. (2015). Trajectories of length, weight, and bone mineral density among preterm infants during the first 12 months of corrected age in China. BMC pediatrics, 15, 91. https://doi.org/10.1186/s12887-015-0396-6
  25. Schulz, E. V., & Wagner, C. L. (2020). History, epidemiology and prevalence of neonatal bone mineral metabolic disorders. Seminars in Fetal & Neonatal Medicine, 25(1), 101069. https://doi.org/10.1016/j.siny.2019.10106
  26. McDevitt, H., Tomlinson, C., White, M. P., & Ahmed, S. F. (2007). Changes in quantitative ultrasound in infants born at less than 32 weeks’ gestation over the first 2 years of life: influence of clinical and biochemical changes. Calcified tissue international, 81(4), 263-269. https://doi.org/10.1007/s00223-007-9064-7
  27. Ukarapong, S., Venkatarayappa, S. K. B., Navarrete, C., & Berkovitz, G. (2017). Risk factors of metabolic bone disease of prematurity. Early Human Development, 112, 29-34. https://doi.org/10.1016/j.earlhumdev.2017.06.010
  28. Savino, F., Viola, S., Benetti, S., Ceratto, S., Tarasco, V., Lupica, M. M., & Cordero di Montezemolo, L. (2013). Quantitative ultrasound applied to metacarpal bone in infants. PeerJ, 1, e141. https://doi.org/10.7717/peerj.141
  29. Jiang, H., Guo, J., Li, J., Li, C., Du, W., Canavese, F., Baker, C., Ying, H., & Hua, J. (2023). Artificial Neural Network Modeling to Predict Neonatal Metabolic Bone Disease in the Prenatal and Postnatal Periods. JAMA network open, 6(1), e2251849. https://doi.org/10.1001/jamanetworkopen.2022.51849
  30. Ritschl, E., Wehmeijer, K., DE Terlizzi, F., Wipfler, E., Cadossi, R., Douma, D., Urlesberger, B., & Müller, W. (2005). Assessment of skeletal development in preterm and term infants by quantitative ultrasound. Pediatric research, 58(2), 341-346. https://doi.org/10.1203/01.PDR.0000169996.25179.EC
  31. Tansug, N., Yildirim, S. A., Canda, E., Ozalp, D., Yilmaz, O., Taneli, F., & Ersoy, B. (2011). Changes in quantitative ultrasound in preterm and term infants during the first year of life. European journal of radiology, 79(3), 428-431. https://doi.org/10.1016/j.ejrad.2010.03.001

Published

2023-08-30

How to Cite

1.
Tsymbal AY, Kotlova YV. Dynamics of changes in the velocity of ultrasound propagation in the bone tissue of premature children according to the data of ultrasound densitometry. Pathologia [Internet]. 2023Aug.30 [cited 2026May28];20(2):154-61. Available from: https://pat.zsmu.edu.ua/article/view/279312

Issue

Section

Original research