Endocrinology Medical News about Fetal Growth

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Different Indices of Fetal Growth Predict Bone Size and Volumetric Density at 4 Years Old
Journal of Bone and Mineral Research, 10/28/09

Harvey NC et al. – The velocity of fetal femur length growth from 19–34 weeks gestation predicted childhood skeletal size at age 4–years whereas the velocity of abdominal growth (a measure of liver volume and adiposity) predicted volumetric density. These results suggest a discordance between influences on skeletal size and volumetric density.

Exclusive Author Commentary
Cyrus Cooper, 10/29/09

Growth in early life is likely to predict risk of osteoporosis in older age. Understanding the relationship between growth patterns in utero and those in postnatal life is key to unravelling the complex processes underlying these observations. We have previously demonstrated that maternal lifestyle, body build and 25(OH)-vitamin D levels in pregnancy predict intrauterine bone mineral accrual. In this current paper we have explored the link between different aspects of pre and postnatal growth. Thus the velocity of fetal femur growth was related to postnatal skeletal size at 4 years old, but rate of growth of fetal abdominal circumference predicted density of the skeleton. Abdominal circumference of the fetus contains contributions from liver volume and subcutaneous fat stores, and we speculate that circulating leptin levels may, in part, underlie this association. This study describes patterns of growth, and the next stage, in addition to exploring these patterns further, will be to link these observations with the prenatal factors already demonstrated to influence offspring skeletal development, and the physiological and molecular mechanisms which may be implicated. These processes are highly likely to be clinically relevant: if the differences in bone density observed at 4 years were retained into adulthood, those individuals who had grown most poorly in utero would be at 50% increased risk of fracture in older age compared with those who had grown best. Thus future investigation of this exciting and novel area of research is essential, to help develop novel strategies to reduce the burden of osteoporotic fracture in future generations.

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