Perinatal factors associate with vertebral size and shape but not lumbar lordosis in 10-year-old children.

Abstract

The intrauterine environment is known to influence foetal development and future health. Low birthweight has been linked to smaller vertebral canals in children and decreased adulthood spine bone mineral content. Perinatal factors affecting lumbar spine curvature have not yet been considered but could be important for adult spinal health, as lumbar movement during lifting, a risk factor for backpain, is associated with lordosis. To investigate this, lumbar spine magnetic resonance images at age 10years and perinatal and maternal data (birthweight, placental weight, gestation length, crown-heel length, maternal age, height, weight and smoking status) from 161 children born in Aberdeen in 1988-1989 were acquired. Statistical shape modelling, using principal component analysis, quantified variations in lumbar spine shape and resulting modes of variation were assessed in combination with perinatal data using correlations and analyses of covariance, adjusted for potential confounders. Spine modes 1-3 (SM1-SM3) captured 75% of the variation in lumbar spine shape. The first and third modes described the total amount (SM1) and evenness of curvature distribution (SM3). SM2 accounted for variations in antero-posterior vertebral diameter relative to vertebral height, increasing positive scores representing a larger relative diameter. Adjusting for gestation length and sex, SM2 positively correlated with birthweight (r=0.25, P<0.01), placental weight (r=0.20, P=0.04), crown-heel length (r=0.36, P<0.001) and maternal weight (r=0.19, P=0.04), and negatively with maternal age (r=-0.22, P=0.02). SM2 scores were lower in girls (P<0.001) and in the low birthweight group (P=0.02). There were no significant differences in SM1 and SM3 scores between birthweight groups, boys and girls or children of smokers (31%) and non-smokers (69%). In conclusion, some perinatal factors were associated with vertebral body morphology but had little effect on lumbar curvature.