A Ireland1, S R Crozier2, A E P Heazell3, K A Ward2, K M Godfrey2,4, H M Inskip2,4, C Cooper2,4,5, N C Harvey6,7. 1. School of Healthcare Science, Manchester Metropolitan University, Manchester, UK. 2. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 3. Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. 4. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. 5. NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK. 6. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. nch@mrc.soton.ac.uk. 7. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. nch@mrc.soton.ac.uk.
Abstract
We compared bone outcomes in children with breech and cephalic presentation at delivery. Neonatal whole-body bone mineral content (BMC) and area were lower in children with breech presentation. At 4 years, no differences in whole-body or spine measures were found, but hip BMC and area were lower after breech presentation. INTRODUCTION: Breech presentation is associated with altered joint shape and hip dysplasias, but effects on bone mineral content (BMC), area (BA) and density (BMD) are unknown. METHODS: In the prospective Southampton Women's Survey mother-offspring cohort, whole-body bone outcomes were measured using dual-energy X-ray absorptiometry (DXA) in 1430 offspring, as neonates (mean age 6 days, n = 965, 39 with a breech presentation at birth) and/or at age 4.1 years (n = 999, 39 breech). Hip and spine bone outcomes were also measured at age 4 years. RESULTS: Neonates with breech presentation had 4.2 g lower whole-body BMC (95% CI -7.4 to - 0.9 g, P = 0.012) and 5.9 cm2 lower BA (- 10.8 to - 1.0 cm2, P = 0.019), but BMD was similar between groups (mean difference - 0.007, - 0.016 to 0.002 g/cm2, P = 0.146) adjusting for sex, maternal smoking, gestational diabetes, mode of delivery, social class, parity, ethnicity, age at scan, birthweight, gestational age and crown-heel length. There were no associations between breech presentation and whole-body outcomes at age 4 years, but, in similarly adjusted models, regional DXA (not available in infants) showed that breech presentation was associated with lower hip BMC (- 0.51, - 0.98 to - 0.04 g, P = 0.034) and BA (- 0.67, - 1.28 to - 0.07 cm2, P = 0.03) but not with BMD (- 0.009, - 0.029 to 0.012 g, P = 0.408), or spine outcomes. CONCLUSIONS: These results suggest that breech presentation is associated with lower neonatal whole-body BMC and BA, which may relate to altered prenatal loading in babies occupying a breech position; these differences did not persist into later childhood. Modest differences in 4-year hip BMC and BA require further investigation.
We compared bone outcomes in children with breech and cephalic presentation at delivery. Neonatal whole-body bone mineral content (BMC) and area were lower in children with breech presentation. At 4 years, no differences in whole-body or spine measures were found, but hip BMC and area were lower after breech presentation. INTRODUCTION: Breech presentation is associated with altered joint shape and hip dysplasias, but effects on bone mineral content (BMC), area (BA) and density (BMD) are unknown. METHODS: In the prospective Southampton Women's Survey mother-offspring cohort, whole-body bone outcomes were measured using dual-energy X-ray absorptiometry (DXA) in 1430 offspring, as neonates (mean age 6 days, n = 965, 39 with a breech presentation at birth) and/or at age 4.1 years (n = 999, 39 breech). Hip and spine bone outcomes were also measured at age 4 years. RESULTS: Neonates with breech presentation had 4.2 g lower whole-body BMC (95% CI -7.4 to - 0.9 g, P = 0.012) and 5.9 cm2 lower BA (- 10.8 to - 1.0 cm2, P = 0.019), but BMD was similar between groups (mean difference - 0.007, - 0.016 to 0.002 g/cm2, P = 0.146) adjusting for sex, maternal smoking, gestational diabetes, mode of delivery, social class, parity, ethnicity, age at scan, birthweight, gestational age and crown-heel length. There were no associations between breech presentation and whole-body outcomes at age 4 years, but, in similarly adjusted models, regional DXA (not available in infants) showed that breech presentation was associated with lower hip BMC (- 0.51, - 0.98 to - 0.04 g, P = 0.034) and BA (- 0.67, - 1.28 to - 0.07 cm2, P = 0.03) but not with BMD (- 0.009, - 0.029 to 0.012 g, P = 0.408), or spine outcomes. CONCLUSIONS: These results suggest that breech presentation is associated with lower neonatal whole-body BMC and BA, which may relate to altered prenatal loading in babies occupying a breech position; these differences did not persist into later childhood. Modest differences in 4-year hip BMC and BA require further investigation.
Entities:
Keywords:
Bone mass; Epidemiology; Foetal growth; Osteoporosis; Pregnancy
Authors: Alex Ireland; Thomas Maden-Wilkinson; Jamie McPhee; Karl Cooke; Marco Narici; Hans Degens; Jörn Rittweger Journal: Med Sci Sports Exerc Date: 2013-09 Impact factor: 5.411
Authors: N C Harvey; M K Javaid; N K Arden; J R Poole; S R Crozier; S M Robinson; H M Inskip; K M Godfrey; E M Dennison; C Cooper Journal: J Dev Orig Health Dis Date: 2010-02 Impact factor: 2.401
Authors: Alex Ireland; Stella Muthuri; Joern Rittweger; Judith E Adams; Kate A Ward; Diana Kuh; Rachel Cooper Journal: J Bone Miner Res Date: 2017-03-27 Impact factor: 6.741
Authors: Imogen S Rogers; Andy R Ness; Colin D Steer; Jonathan C K Wells; Pauline M Emmett; John R Reilly; Jon Tobias; George Davey Smith Journal: Am J Clin Nutr Date: 2006-10 Impact factor: 7.045
Authors: Christopher R Holroyd; Clive Osmond; David Jp Barker; Sue M Ring; Debbie A Lawlor; Jon H Tobias; George Davey Smith; Cyrus Cooper; Nicholas C Harvey Journal: J Bone Miner Res Date: 2016-04-22 Impact factor: 6.741
Authors: Ines Foessl; J H Duncan Bassett; Åshild Bjørnerem; Björn Busse; Ângelo Calado; Pascale Chavassieux; Maria Christou; Eleni Douni; Imke A K Fiedler; João Eurico Fonseca; Eva Hassler; Wolfgang Högler; Erika Kague; David Karasik; Patricia Khashayar; Bente L Langdahl; Victoria D Leitch; Philippe Lopes; Georgios Markozannes; Fiona E A McGuigan; Carolina Medina-Gomez; Evangelia Ntzani; Ling Oei; Claes Ohlsson; Pawel Szulc; Jonathan H Tobias; Katerina Trajanoska; Şansın Tuzun; Amina Valjevac; Bert van Rietbergen; Graham R Williams; Tatjana Zekic; Fernando Rivadeneira; Barbara Obermayer-Pietsch Journal: Front Endocrinol (Lausanne) Date: 2021-12-01 Impact factor: 5.555
Authors: Stefaan W Verbruggen; Bernhard Kainz; Susan C Shelmerdine; Owen J Arthurs; Joseph V Hajnal; Mary A Rutherford; Andrew T M Phillips; Niamh C Nowlan Journal: J Biomech Date: 2018-07-20 Impact factor: 2.712
Authors: Monika Frysz; Jon H Tobias; Deborah A Lawlor; Richard M Aspden; Jennifer S Gregory; Alex Ireland Journal: J Musculoskelet Neuronal Interact Date: 2020-09-01 Impact factor: 2.041