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Review
. 2023 Aug 9;15(16):3515.
doi: 10.3390/nu15163515.

Prenatal and Neonatal Bone Health: Updated Review on Early Identification of Newborns at High Risk for Osteopenia

Serafina Perrone  1 , Chiara Caporilli  2 , Federica Grassi  2 , Mandy Ferrocino  2 , Eleonora Biagi  2 , Valentina Dell'Orto  1 , Virginia Beretta  1 , Chiara Petrolini  1 , Lucia Gambini  1 , Maria Elisabeth Street  2 , Andrea Dall'Asta  3 , Tullio Ghi  3 , Susanna Esposito  2
Affiliations
Review

Prenatal and Neonatal Bone Health: Updated Review on Early Identification of Newborns at High Risk for Osteopenia

Serafina Perrone et al. Nutrients. .

Abstract

Bone health starts with maternal health and nutrition, which influences bone mass and density already in utero. The mechanisms underlying the effect of the intrauterine environment on bone health are partly unknown but certainly include the 'foetal programming' of oxidative stress and endocrine systems, which influence later skeletal growth and development. With this narrative review, we describe the current evidence for identifying patients with risk factors for developing osteopenia, today's management of these populations, and screening and prevention programs based on gestational age, weight, and morbidity. Challenges for bone health prevention include the need for new technologies that are specific and applicable to pregnant women, the foetus, and, later, the newborn. Radiofrequency ultrasound spectrometry (REMS) has proven to be a useful tool in the assessment of bone mineral density (BMD) in pregnant women. Few studies have reported that transmission ultrasound can also be used to assess BMD in newborns. The advantages of this technology in the foetus and newborn are the absence of ionising radiation, ease of use, and, above all, the possibility of performing longitudinal studies from intrauterine to extrauterine life. The use of these technologies already in the intrauterine period could help prevent associated diseases, such as osteoporosis and osteopenia, which are characterised by a reduction in bone mass and degeneration of bone structure and lead to an increased risk of fractures in adulthood with considerable social repercussions for the related direct and indirect costs.

Keywords: bone mineral density; endocrine disruptors; newborn infant; oxidative stress; ultrasounds.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Factors affecting bone mineralization: maternal, foetal, and neonatal risk and protective factors.
Figure 2
Figure 2
Schematic representation on the role of miRNAs in bone development. miR = microRNA; GH: growth hormone; PTHrP: parathyroid hormone-related protein.
Figure 3
Figure 3
Algorithm proposal: integrated use of laboratory and urinary tests with new technologies for the assessment of bone mineralization levels.
See this image and copyright information in PMC

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References

    1. Masztalerz-Kozubek D., Zielinska-Pukos M.A., Hamulka J. Maternal Diet, Nutritional Status, and Birth-Related Factors Influencing Offspring’s Bone Mineral Density: A Narrative Review of Observational, Cohort, and Randomized Controlled Trials. Nutrients. 2021;13:2302. doi: 10.3390/nu13072302. - DOI - PMC - PubMed
    1. Baird J., Kurshid M.A., Kim M., Harvey N., Dennison E., Cooper C. Does birthweight predict bone mass in adulthood? A systematic review and meta-analysis. Osteoporos. Int. 2011;22:1323–1334. doi: 10.1007/s00198-010-1344-9. - DOI - PubMed
    1. Godfrey K., Walker-Bone K., Robinson S., Taylor P., Shore S., Wheeler T., Cooper C. Neonatal bone mass: Influence of parental birthweight, maternal smoking, body composition, and activity during pregnancy. J. Bone Miner. Res. 2001;16:1694–1703. doi: 10.1359/jbmr.2001.16.9.1694. - DOI - PubMed
    1. Lanham S.A., Roberts C., Perry M.J., Cooper C., Oreffo R.O. Intrauterine programming of bone. Part 2: Alteration of skeletal structure. Osteoporos. Int. 2008;19:157–167. doi: 10.1007/s00198-007-0448-3. - DOI - PubMed
    1. Rustico S.E., Calabria A.C., Garber S.J. Metabolic bone disease of prematurity. J. Clin. Transl. Endocrinol. 2014;1:85–91. doi: 10.1016/j.jcte.2014.06.004. - DOI - PMC - PubMed

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This research received no external funding.