title: Prevalence and characteristics of rib fractures in ex-preterm infants.
abstract: OBJECTIVE
  This study aimed to identify the prevalence and characteristics of rib fractures in ex-preterm infants.
  
  
  METHODS
  Infants born at <37 weeks' gestation and admitted before 2011 to 3 regional neonatal units were identified from admission registers. For 2 centers, these data were available from 2000 onward and, for another center, from 2005. Electronic records were searched to identify chest radiographs performed up to age 1 year. Chest radiograph reports were then reviewed for evidence of rib fractures, and the case notes of all affected individuals were scrutinized.
  
  
  RESULTS
  Of the 3318 eligible preterm infants, 1446 had a total of 9386 chest radiographs. Of these infants, 26 (1.8%) were identified as having a total of 62 rib fractures. Their median (range) gestation at birth was 26 weeks (23-34). The median chronological age of these infants at the time of the radiograph was 14 weeks (5 weeks to 8 months). The median corrected gestational age at the time of the radiograph was 39 weeks (34 weeks to 4 months). Of the 62 fractures, 27 (36%) were sited posteriorly, and 15 (53%) of the infants with posterior rib fractures were diagnosed with osteopathy of prematurity. Classic risk including conjugated hyperbilirubinemia and diuretics, were present in 23 of 26 (88%) infants. A full skeletal survey was performed in 8 of 26 (31%). Investigations for nonaccidental injury occurred in 4 of 26 (15%) cases.
  
  
  CONCLUSIONS
  Evidence of rib fractures is present in ~2% of ex-preterm infants. The evaluation of these fractures in infancy requires a detailed neonatal history irrespective of the site of rib fracture.
authors.affiliation: Section of Child Health, Royal Hospital for Sick Children, Yorkhill, Glasgow, United Kingdom.
authors.forename: Angela
authors.initials: A
authors.lastname: Lucas-Herald
authors.forename: Sandra
authors.initials: S
authors.lastname: Butler
authors.forename: Helen
authors.initials: H
authors.lastname: Mactier
authors.forename: Helen
authors.initials: H
authors.lastname: McDevitt
authors.forename: David
authors.initials: D
authors.lastname: Young
authors.forename: Syed Faisal
authors.initials: SF
authors.lastname: Ahmed
mesh_terms: D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D002649:Child Abuse / Q000175:diagnosis / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D007363:Intensive Care Units, Neonatal; D008297:Male; D008403:Mass Screening; D011859:Radiography; D012253:Rib Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012606:Scotland