title: Bone density among infants of gestational diabetic mothers and macrosomic neonates.
abstract: Decreased bone density has been found among infants of diabetic mothers and among large-for-gestational-age newborns. To evaluate which etiologies (physical or metabolic effect) have the greatest impact on neonatal bone density. A case-control study was conducted that included two study groups: one comprising 20 appropriate-for-gestational-age (AGA) infants of gestational diabetic mothers (IGDM) and matched controls, and the other comprising 20 macrosomic infants (birth weight > 4 kg) and matched controls. Bone density was examined along the tibia bone using quantitative ultrasound that measured speed of sound. Bone density among the group of macrosomic infants was significantly lower than among the control group (2,976 vs. 3,120 m/s respectively, p < 0.005). No differences in bone density were found between infants of diabetic mothers and their controls (3,005 vs. 3,043 m/s respectively, p = 0.286). Low bone density was predicted only by birth weight (for every increase of 100 g) (OR 1.148 [CI 1.014-1.299], p = 0.003). Bone density was found to be low among macrosomic newborn infants, whereas among AGA-IGDM infants bone density was similar to that of the control group. These findings strengthen the hypothesis that reduced fetal movements secondary to fetal macrosomia constitute the mechanism for reduced bone density.
authors.affiliation: Department of Neonatology, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 52621, Ramat Gan, Israel.
authors.forename: Irit
authors.initials: I
authors.lastname: Schushan-Eisen
authors.forename: Mor
authors.initials: M
authors.lastname: Cohen
authors.forename: Leah
authors.initials: L
authors.lastname: Leibovitch
authors.forename: Ayala
authors.initials: A
authors.lastname: Maayan-Metzger
authors.forename: Tzipora
authors.initials: T
authors.lastname: Strauss
mesh_terms: D001724:Birth Weight; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005320:Fetal Macrosomia / Q000000981:diagnostic imaging* / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D013977:Tibia / Q000000981:diagnostic imaging*; D016216:Ultrasonography, Prenatal / Q000379:methods