Foetal and postnatal growth and bone mass at 6 months: the Generation R Study.
OBJECTIVE
To examine whether parental, foetal and postnatal characteristics and growth patterns in foetal life and infancy are associated with bone mass at 6 months, as bone acquisition seems to be associated with genetic and environmental factors.


METHODS
This study was embedded in the Generation R Study, a prospective cohort from early foetal life onwards.


METHODS
Bone mineral density (BMD) and bone mineral content (BMC) total body (TB) and BMD lumbar spine (LS) were measured by dual-energy X-ray absorptiometry in 252 infants at 6 months. Parental, foetal and postnatal data were collected by physical and foetal ultrasound examinations and questionnaires.


RESULTS
Maternal, foetal and postnatal anthropometrics were positively associated with BMD(TB) and BMC(TB) at 6 months, but only postnatal anthropometrics were associated with BMD(LS) . A gain in weight-SD-score during foetal life and prenatal catch-up in weight were positively associated with BMD(TB) . After birth, a gain in weight-SD-score was positively associated with BMD(LS) and bone mineral apparent density (BMAD(LS) ). The effect was strongest between 6 weeks and 6 months. Catch-up in weight was associated with a lower probability of low (lowest quartile of) BMD(TB) and BMD(LS) . Children remaining in the first tertile of weight from birth to 6 months had a much higher risk of low BMD(TB) at 6 months [OR (95% CI): 15 (2, 88)].


CONCLUSIONS
Our findings suggest that growth patterns in foetal and postnatal life are associated with bone mass in infancy and may have consequences for bone mass in later life. Follow-up studies are needed to assess whether and to what extent maternal anthropometrics, foetal and postnatal growth patterns have an effect on bone status in adulthood.
The Generation R Study Group, Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands. l.ay@erasmusmc.nl
Lamise
L
Ay
Vincent W V
VW
Jaddoe
Albert
A
Hofman
Henriëtte A
HA
Moll
Hein
H
Raat
Eric A P
EA
Steegers
Anita C S
AC
Hokken-Koelega
D015502:Absorptiometry, Photon; D000328:Adult; D001823:Body Composition / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D011795:Surveys and Questionnaires