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Decrausaz S, Shirley MK, Stock JT, Williams JE, Fewtrell MS, Clark CA, Arthurs OJ, Wells JCK. Evaluation of dual-energy X-ray absorptiometry compared to magnetic resonance imaging for collecting measurements of the human bony pelvis. Am J Hum Biol 2022; 34:e23753. [PMID: 35460113 PMCID: PMC9541267 DOI: 10.1002/ajhb.23753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Imaging methods to measure the human pelvis in vivo provide opportunities to better understand pelvic variation and adaptation. Magnetic resonance imaging (MRI) provides high-resolution images, but is more expensive than dual-energy X-ray absorptiometry (DXA). We sought to compare pelvic breadth measurements collected from the same individuals using both methods, to investigate if there are systematic differences in pelvic measurement between these imaging methods. METHODS Three pelvic breadth dimensions (bi-iliac breadth, bi-acetabular breadth, medio-lateral inlet breadth) were collected from MRI and DXA scans of a cross-sectional sample of healthy, nulliparous adult women of South Asian ancestry (n = 63). Measurements of MRI and DXA pelvic dimensions were collected four times in total, with one baseline data collection session and three replications. Data collected from these sessions were averaged, used to calculate technical error of measurement and entered into a Bland-Altman analysis. Linear regression models were fitted with a given MRI pelvic measurement regressed on the same measurement collected from DXA scans, as well as MRI mean bias regressed on DXA mean bias. RESULTS Technical error of measurement was higher in DXA measurements of bi-iliac breadth and medio-lateral pelvic inlet breadth and higher for MRI measurements of bi-acetabular breadth. Bland Altman analyses showed no statistically significant relationship between the mean bias of MRI and DXA, and the differences between MRI and DXA pelvic measurements. CONCLUSIONS DXA measurements of pelvic breadth are comparable to MRI measurements of pelvic breadth. DXA is a less costly imaging technique than MRI and can be used to collect measurements of skeletal elements in living people.
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Affiliation(s)
- Sarah‐Louise Decrausaz
- Department of ArchaeologyUniversity of CambridgeCambridgeUK,Department of AnthropologyUniversity of VictoriaVictoriaCanada
| | - Meghan K. Shirley
- Population, Policy, and Practice Research and Teaching DepartmentChildhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child HealthLondonUK,Division of GI, Hepatology and NutritionThe Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Jay T. Stock
- Department of ArchaeologyUniversity of CambridgeCambridgeUK,Department of AnthropologyWestern UniversityLondonCanada,Department of ArchaeologyMax Planck Centre for the Science of Human HistoryJenaGermany
| | - Jane E. Williams
- Population, Policy, and Practice Research and Teaching DepartmentChildhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Mary S. Fewtrell
- Population, Policy, and Practice Research and Teaching DepartmentChildhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Chris A. Clark
- Population, Policy, and Practice Research and Teaching DepartmentChildhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Owen J. Arthurs
- Population, Policy, and Practice Research and Teaching DepartmentChildhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child HealthLondonUK
| | - Jonathan C. K. Wells
- Population, Policy, and Practice Research and Teaching DepartmentChildhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child HealthLondonUK
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Decrausaz SL, Cameron ME. A growth area: A review of the value of clinical studies of child growth for palaeopathology. Evol Med Public Health 2022; 10:108-122. [PMID: 35273803 PMCID: PMC8903130 DOI: 10.1093/emph/eoac005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/17/2022] [Indexed: 12/11/2022] Open
Abstract
Studies of living children demonstrate that early life stress impacts linear growth outcomes. Stresses affecting linear growth may also impact later life health outcomes, including increased cardiometabolic disease risk. Palaeopathologists also assess the growth of children recovered from bioarchaeological contexts. Early life stresses are inferred to affect linear growth outcomes, and measurements of skeletal linear dimensions alongside other bioarchaeological information may indicate the types of challenges faced by past groups. In clinical settings, the impacts of stress on growing children are typically measured by examining height. Palaeopathologists are limited to examining bone dimensions directly and must grapple with incomplete pictures of childhood experiences that may affect growth. Palaeopathologists may use clinical growth studies to inform observations among past children; however, there may be issues with this approach. Here, we review the relationship between contemporary and palaeopathological studies of child and adolescent growth. We identify approaches to help bridge the gap between palaeopathological and biomedical growth studies. We advocate for: the creation of bone-specific growth reference information using medical imaging and greater examination of limb proportions; the inclusion of children from different global regions and life circumstances in contemporary bone growth studies; and greater collaboration and dialogue between palaeopathologists and clinicians as new studies are designed to assess linear growth past and present. We advocate for building stronger bridges between these fields to improve interpretations of growth patterns across human history and to potentially improve interventions for children living and growing today. Studies of living children demonstrate that early life stress impacts linear growth. Stresses affecting linear growth may also impact later life health, including cardiometabolic disease risk. Palaeopathologists also investigate if children and adolescents recovered from bioarchaeological contexts experienced growth disruptions due to early life challenges. In clinical settings, the impacts of stress on growing children are typically measured by examining height. Palaeopathologists are limited to examining bone dimensions directly and must grapple with incomplete pictures of childhood experiences that may affect growth. Here, we review the relationship between contemporary and palaeopathological studies of child and adolescent growth. We advocate for: the creation of bone-specific growth reference information using medical imaging and greater examination of limb proportions; the inclusion of children from different global regions and life circumstances in contemporary bone growth studies; and greater collaboration and dialogue between palaeopathologists and clinicians as new studies are designed to assess linear growth past and present. These steps may improve interpretations of growth patterns across human history and interventions for children living and growing today.
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Affiliation(s)
- Sarah-Louise Decrausaz
- Department of Anthropology, University of Victoria, Cornett Building, Victoria, BC V8P 5C2, Canada
| | - Michelle E Cameron
- Department of Anthropology, University of Toronto, 19 Ursula Franklin Street, Toronto, ON M5S 2S2, Canada
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3
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Zhang Y, Shu S, Gu Q, Mandelli F, Zhang T, Jing W, Qiu Y, Zhu Z, Bao H. Radiographic study of peak velocity of pelvic incidence in adolescent idiopathic scoliosis. Quant Imaging Med Surg 2022; 12:1130-1138. [PMID: 35111610 DOI: 10.21037/qims-21-391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/03/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pelvic incidence (PI), a parameter related to the ideal spinopelvic alignment, is a morphological parameter that is usually considered fixed, but the PI's growth during adolescence has been reported. We investigated the peak PI velocity during adolescence and describe the relationship between increasing PI and changes in the morphology of the pelvis and sacrum. METHODS We measured standing height (SH) and radiological anatomical parameters including pelvic height (PH), pelvic width (PW), sacral width (SW), femoral head-sacrum (FH-S), sacrum-coccyx (S-C) length, and S-C distance at each follow-up of 76 adolescent idiopathic scoliosis (AIS) patients. ΔParameter was the difference between the next measurement and the previous one. Growth velocity was ΔParameter divided by time interval. All ΔParameters were compared between different Risser stages using repeated-measures analysis of variance (ANOVA). The Pearson coefficients of correlation were calculated to assess the relationships between PI and ΔParameters. RESULTS PI reached peak growth with a 1.6°/year growth in females and 1.8°/year in males at Risser stage 1. PI tended to grow rapidly with Risser 0 and closed triradiate cartilage (female: 1.3°/year and male: 1.4°/year) and to slow down at Risser 2 (female: 1.2°/year and male: 1.3°/year). ΔPI strongly correlated with ΔFH-S (R>0.508, P<0.05) and also correlated with ΔSH, ΔPH, ΔPW, ΔSW, and ΔS-C length (R>0.192, P<0.05) but not correlated with ΔS-C distance and ΔS-C ratio. CONCLUSIONS In patients with AIS, the peak PI velocity is at Risser 1, and it is still increasing at Risser 5. Our result suggested that the growth of the PI may be associated with SH and changing pelvic morphology during skeletal growth of adolescence.
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Affiliation(s)
- Yuancheng Zhang
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.,Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
| | - Shibin Shu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Qi Gu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Filippo Mandelli
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
| | - Tianyuan Zhang
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Wenting Jing
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Yong Qiu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Zezhang Zhu
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - Hongda Bao
- Department of Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
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Abstract
Maternal mortality remains one of the leading causes of death in women of reproductive age in developing countries, and a major concern in some developed countries. It is puzzling why such a condition has not been reduced in frequency, if not eliminated, in the course of evolution. Maternal mortality is a complex phenomenon caused by several physiological and physical factors. Among the physical factors, maternal mortality due to fetopelvic disproportion remains controversial. Several explanations including evolution of bipedal locomotion, rapid brain growth, and nutritional changes and life style changes in settler communities have been proposed. The influences of human reproductive biology and sexual selection have rarely been considered to explain why maternal mortality persisted through human evolution. We entertain the hypothesis that irrespective of the causes, the risks of all factors causing maternal mortality would be aggravated by disassortative mating, specifically male preference for younger females who are generally small statured and at higher risk of obstetric complications. Maternal mortality arising due to sexual selection and mate choice would have the long-term effect of driving widowers toward younger women, often resulting in "child marriage," which still remains a significant cause of maternal mortality globally. Evolutionarily, such a male driven mating system in polygamous human populations would have prolonged the persistence of maternal mortality despite selection acting against it. The effects may extend beyond maternal mortality because male-mate choice driven maternal mortality would reduce average reproductive life spans of women, thus influencing the evolution of menopause.
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Affiliation(s)
- Santosh Jagadeeshan
- 1 Department of Biology, McMaster University, Hamilton, Canada.,2 Department of Physiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Alyssa K Gomes
- 1 Department of Biology, McMaster University, Hamilton, Canada
| | - Rama S Singh
- 1 Department of Biology, McMaster University, Hamilton, Canada
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Predicting the location of the hip joint centres, impact of age group and sex. Sci Rep 2016; 6:37707. [PMID: 27883044 PMCID: PMC5121588 DOI: 10.1038/srep37707] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/03/2016] [Indexed: 11/20/2022] Open
Abstract
Clinical gait analysis incorporating three-dimensional motion analysis plays a key role in planning surgical treatments in people with gait disability. The position of the Hip Joint Centre (HJC) within the pelvis is thus critical to ensure accurate data interpretation. The position of the HJC is determined from regression equations based on anthropometric measurements derived from relatively small datasets. Current equations do not take sex or age into account, even though pelvis shape is known to differ between sex, and gait analysis is performed in populations with wide range of age. Three dimensional images of 157 deceased individuals (37 children, 120 skeletally matured) were collected with computed tomography. The location of the HJC within the pelvis was determined and regression equations to locate the HJC were developed using various anthropometrics predictors. We determined if accuracy improved when age and sex were introduced as variables. Statistical analysis did not support differentiating the equations according to sex. We found that age only modestly improved accuracy. We propose a range of new regression equations, derived from the largest dataset collected for this purpose to date.
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6
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Grow first, gain fat in the meantime. Longitudinal study of anthropometric changes around menarche. ANTHROPOLOGICAL REVIEW 2015. [DOI: 10.1515/anre-2015-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
There is a long dispute among anthropologist over which factor is more important – skeletal maturation or energy accumulation – for menarche occurrence. Here we report results of longitudinal study conducted on the sample of 178 girls followed for the period from 2 years before to 2 years after the age of menarche. Each year during this period anthropometric measures of waist and hip circumference, pelvis breadth, subscapular, triceps and abdominal skinfold thickness were taken to document girls’ physical development. We found that changes in hip circumference and pelvis breadth were the most closely associated with menarche appearance. We also found that changes in anthropometric measures of lower body part preceded changes in anthropometric measures of upper body part and tended to peak one year before menarche occurrence while changes in upper body part tended to peak one year after menarche occurrence. These results suggest that both skeletal maturation and energy accumulation in the form of fat are equally important for menarche to occur. Furthermore, we are proposing a new indicator describing allometric changes of pelvis around menarche: hip circumference to pelvis breadth ratio (HCPBR).
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7
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Rantalainen T, Weeks BK, Nogueira RC, Beck BR. Effects of bone-specific physical activity, gender and maturity on tibial cross-sectional bone material distribution: a cross-sectional pQCT comparison of children and young adults aged 5-29 years. Bone 2015; 72:101-8. [PMID: 25465388 DOI: 10.1016/j.bone.2014.11.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/04/2014] [Accepted: 11/18/2014] [Indexed: 01/26/2023]
Abstract
Growth is the opportune time to modify bone accrual. While bone adaptation is known to be dependent on local loading and consequent deformations (strain) of bone, little is known about the effects of sex, and bone-specific physical activity on location-specific cross-sectional bone geometry during growth. To provide more insight we examined bone traits at different locations around tibial cross sections, and along the tibia between individuals who vary in terms of physical activity exposure, sex, and pubertal status. Data from 304 individuals aged 5-29 years (172 males, 132 females) were examined. Peripheral quantitative computed tomography (pQCT) was applied at 4%, 14%, 38%, and 66% of tibial length. Maturity was established by estimating age at peak height velocity (APHV). Loading history was quantified with the bone-specific physical activity questionnaire (BPAQ). Comparisons, adjusted for height, weight and age were made between sex, maturity, and BPAQ tertile groups. Few to no differences were observed between sexes or BPAQ tertiles prior to APHV, whereas marked sexual dimorphism and differences between BPAQ tertiles were observed after APHV. Cross-sectional location-specific differences between BPAQ tertiles were not evident prior to APHV, whereas clear location-specificity was observed after APHV. In conclusion, the skeletal benefits of physical activity are location-specific in the tibia. The present results indicate that the peri- or post-pubertal period is likely a more favourable window of opportunity for enhancing cross-sectional bone geometry than pre-puberty. Increased loading during the peri-pubertal period may enhance the bone of both sexes.
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Affiliation(s)
- Timo Rantalainen
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
| | - Benjamin K Weeks
- Griffith Health Institute, Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Rossana C Nogueira
- Griffith Health Institute, Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Belinda R Beck
- Griffith Health Institute, Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
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8
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Zhu Y, Hernandez LM, Dong Y, Himes JH, Hirschfeld S, Forman MR. Longer breastfeeding duration reduces the positive relationships among gestational weight gain, birth weight and childhood anthropometrics. J Epidemiol Community Health 2015; 69:632-8. [PMID: 25680365 DOI: 10.1136/jech-2014-204794] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/18/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND The relationship between gestational weight gain (GWG) and childhood growth remains controversial. An examination on whether infant feeding practices mediate this relationship may improve our understanding of it. METHODS We investigated whether the relationships among GWG, birth weight and childhood anthropometrics were mediated through infant feeding practices (breastfeeding duration and age at introduction of solid foods) in a cross-sectional multiethnic study of 1387 mothers and their children aged 0-5.9 years in the USA (2011-2012). Child anthropometrics included age-specific and sex-specific z-scores for weight-for-age (WAZ), height/length-for-age (HAZ), weight-for-height/length (WHZ) and body mass index-for-age (BMIZ); and ulnar length, a marker for limb growth. We used structural equation modelling to calculate standardised path coefficients and total, direct and indirect associations of GWG, birth weight and infant feeding practices with child anthropometrics. RESULTS Maternal GWG had a positive indirect association with all anthropometrics mediated via birth weight, whereas longer breastfeeding duration reduced the positive associations of GWG and birth weight with WAZ, WHZ and BMIZ in non-Hispanics (β=-0.077, -0.064 and -0.106, respectively). Longer breastfeeding duration and introducing solid foods at a later age were positively associated with ulnar length (β=0.023 and 0.030, respectively) but not HAZ, suggesting a distinct association, for the first time, with limb growth. CONCLUSIONS Findings suggest that promoting longer breastfeeding duration among women with excessive GWG who had high birthweight newborns may mitigate the potential for their offspring to develop obesity. In addition, findings reinforce the importance of promoting appropriate GWG and preventing high birth weight, which are positively associated with childhood anthropometrics.
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Affiliation(s)
- Yeyi Zhu
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Ladia M Hernandez
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Yongquan Dong
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - John H Himes
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Steven Hirschfeld
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Michele R Forman
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
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Mujugira A, Osoti A, Deya R, Hawes SE, Phipps AI. Fetal head circumference, operative delivery, and fetal outcomes: a multi-ethnic population-based cohort study. BMC Pregnancy Childbirth 2013; 13:106. [PMID: 23651454 PMCID: PMC3653751 DOI: 10.1186/1471-2393-13-106] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 05/02/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Operative delivery procedures, such as primary cesarean section, vacuum-assisted, and forceps-assisted vaginal delivery increase maternal and fetal morbidity, and the cost of care. We evaluated whether large fetal head circumference (FHC) independently increases risk of such interventions, as well as fetal distress or low Apgar score, in anatomically normal infants. METHODS We conducted a population-based retrospective cohort study using Washington State birth certificate data. We included singleton, term infants born to nulliparous mothers from 2003-2009. We compared mode of delivery and fetal outcomes in 10,750 large-FHC (37-41 cm) infants relative to 10,750 average-FHC (34 cm) infants, frequency matched by birth-year. RESULTS Large-FHC infants were nearly twice as likely to be delivered by primary cesarean section as average-FHC infants (unadjusted relative risk [RR] 1.84, 95% confidence interval [CI]: 1.77, 1.92). The RR for primary cesarean section associated with large-FHC was largest for mothers aged 19 years or less (RR 2.28; 95% CI: 1.99, 2.61), and smallest for mothers aged 35 years or greater (RR 1.51; 95% CI: 1.37, 1.66) [test of homogeneity, p < 0.001]. Large-FHC infants were at increased risk of vacuum-assisted vaginal delivery (RR 1.55; 95% CI: 1.43, 1.69), and forceps-assisted vaginal delivery (RR 1.61; 95% CI: 1.32, 1.97). There was no difference in risk of fetal distress (RR 0.97; 95% CI: 0.89, 1.07) for large-FHC versus average-FHC infants. Risk estimates were unaffected by adjustment for potential confounders. CONCLUSIONS Nulliparous mothers of large-FHC infants are at increased risk of primary cesarean section, vacuum-assisted and forceps-assisted vaginal delivery relative to mothers of average-FHC infants. Maternal age modifies the association between FHC and primary cesarean section.
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Affiliation(s)
- Andrew Mujugira
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- International Clinical Research Center, Department of Global Health, University of Washington, 325 Ninth Avenue, Box 359927, Seattle, WA, 98104, USA
| | - Alfred Osoti
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Ruth Deya
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Amanda I Phipps
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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10
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Moilanen P, Määttä M, Kilappa V, Xu L, Nicholson PHF, Alén M, Timonen J, Jämsä T, Cheng S. Discrimination of fractures by low-frequency axial transmission ultrasound in postmenopausal females. Osteoporos Int 2013; 24:723-30. [PMID: 22638711 DOI: 10.1007/s00198-012-2022-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
Abstract
SUMMARY In this cross-sectional study, 95 postmenopausal women, with and without fracture history, were measured by low-frequency axial transmission ultrasound. The measured ultrasound velocity discriminated the fractured subjects from the nonfractured ones equally or better than peripheral quantitative computed tomography (pQCT) and dual energy x-ray absorptiometry (DXA). These results suggest that low-frequency ultrasound is suitable for bone fragility assessment. INTRODUCTION Quantitative low-frequency axial transmission ultrasound is a promising modality for assessing mineral density and geometrical properties of long bones such as radius and tibia. The aim of the current study was to evaluate the ability of low-frequency axial transmission ultrasound to discriminate fractures retrospectively in postmenopausal women. METHODS A cross-sectional study involved 95 female subjects aged 45-88 years, whose fracture information was gathered retrospectively. The fracture group was defined as subjects with one or more low-/moderate-energy fractures. The radius and tibial shaft were measured with a custom-made ultrasonometer to assess the velocity of the low-frequency first-arriving signal (V (LF)). Site-matched pQCT was used to measure volumetric cortical and subcortical bone mineral density (sBMD), and cortical thickness (CTh). Areal BMD (aBMD) was measured using DXA for the whole body (WB), lumbar spine, and hip. RESULTS The majority (19/32; 59 %) of the fractures were in the upper limb. V (LF) in the radius, but not in the tibia, discriminated fractures with an age- and BMI-adjusted odds ratio (OR) of 2.06 (95 % CI 1.21-3.50, p < 0.01). In the radius, CTh and cortical BMD (CBMD) significantly discriminated fractures, as did the total, cortical, and sBMD in the tibia (adjusted OR 1.35-2.15, p < 0.05). Sensitivity and specificity were similar among all the measurements (area under the receiver operating characteristic curve 0.74-0.81, p < 0.001). CONCLUSIONS Low-frequency axial transmission ultrasound in the radius was able to discriminate fractured subjects from the nonfractured ones. This suggests that low-frequency axial transmission ultrasound has the potential to assess bone fragility in postmenopausal women.
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Affiliation(s)
- P Moilanen
- Department of Physics, University of Jyväskylä, P.O. Box 35, Jyväskylä, FI-40014, Finland.
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11
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Wiklund PK, Xu L, Wang Q, Mikkola T, Lyytikäinen A, Völgyi E, Munukka E, Cheng SM, Alen M, Keinänen-Kiukaanniemi S, Cheng S. Lactation is associated with greater maternal bone size and bone strength later in life. Osteoporos Int 2012; 23:1939-45. [PMID: 21927916 DOI: 10.1007/s00198-011-1790-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 09/01/2011] [Indexed: 11/24/2022]
Abstract
SUMMARY The association between lactation and bone size and strength was studied in 145 women 16 to 20 years after their last parturition. Longer cumulative duration of lactation was associated with larger bone size and strength later in life. INTRODUCTION Pregnancy and lactation have no permanent negative effect on maternal bone mineral density but may positively affect bone structure in the long term. We hypothesized that long lactation promotes periosteal bone apposition and hence increasing maternal bone strength. METHODS Body composition, bone area, bone mineral content, and areal bone mineral density of whole body and left proximal femur were assessed using DXA, and cross-sectional area and volumetric bone mineral density of the left tibia shaft were measured by pQCT in 145 women (mean age 48 years, range 36-60 years) 16 to 20 years after their last parturition. Hip (HSI) and tibia strength indexes (TBSI) were calculated. Medical history and lifestyle factors including breastfeeding patterns and durations were collected via a self-administered questionnaire. Weight change during each pregnancy was collected from personal maternity tracking records. RESULTS Sixteen to 20 years after the last parturition, women who had breastfed in total more than 33 months in their life, regardless of the number of children, had greater bone strength estimates of the hip (HSI = 1.92 vs. 1.61) and the tibia (TBSI = 5,507 vs. 4,705) owing to their greater bone size than mothers who had breastfed less than 12 months (p < 0.05 for all). The differences in bone strength estimates were independent of body height and weight, menopause status, use of hormone replacement therapy, and present leisure time physical activity level. CONCLUSION Breastfeeding is beneficial to maternal bone strength in the long run.
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Affiliation(s)
- P K Wiklund
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35 (LL), 40014, Jyväskylä, Finland
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12
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The effect of pelvic size on cesarean delivery rates: using adolescent maternal age as an unbiased proxy for pelvic size. J Pediatr Adolesc Gynecol 2012; 25:190-4. [PMID: 22578479 DOI: 10.1016/j.jpag.2012.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 12/27/2011] [Accepted: 01/03/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Dystocia, the presence of abnormal labor, is the most common indication for cesarean delivery. Risk factors for dystocia include abnormalities of expulsatile forces during labor, fetal factors, and maternal pelvic size abnormalities. The objective of our study was to evaluate the effect of pelvic size on the risk of cesarean delivery rates using adolescent maternal age as an unbiased determinant of pelvic size. METHODS We conducted a population-based cohort study using the Center for Disease Control and Prevention's Linked Birth-Infant Death and Fetal Death data on all births in the US between 1995 and 2004 for women aged 12 to 20. We excluded all births of gestational age under 24 weeks and those with reported congenital malformations or chromosomal abnormalities. Maternal age and mode of delivery information was obtained from the birth records. RESULTS There were 6,188,704 births in our cohort of which 1,863 were to women aged 12; 12,903 to women aged 13; 68,890 to women aged 14, and the remainder to women aged 15 and above. Cesarean delivery rates were highest amongst women aged 12 at 19.59 % and declined to 13.92% amongst 15 year-olds, and 14.84 % amongst 20 year olds. This effect was more pronounced when the analysis was restricted to macrosomic fetuses (P<0.005). CONCLUSION Cesarean delivery rates increase the younger the maternal age is suggesting that pelvic factors can play an important role in dystocia.
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