Abstract
ObjectivesIn this study we investigate the relationships between placental size and neonatal bone mass and body composition, in a population-based cohort. Study design914 mother–neonate pairs were included. Placental dimensions were measured via ultrasound at 19 weeks gestation. Dual X-ray absorptiometry (DXA) was performed on the neonates within the first two weeks of life. ResultsWe observed positive relationships between placental volume at 19 weeks, and neonatal bone area (BA; r = 0.26, p < 0.001), bone mineral content (BMC; r = 0.25, p < 0.001) and bone mineral density (BMD; r = 0.10, p = 0.001). Thus placental volume accounted for 6.25% and 1.2% of the variation in neonatal BMC and BMD respectively at birth. These associations remained after adjustment for maternal factors previously shown to be associated with neonatal bone mineral accrual (maternal height, smoking, walking speed in late pregnancy, serum 25(OH) vitamin D and triceps skinfold thickness). ConclusionsWe found that placental volume at 19 weeks gestation was positively associated with neonatal bone size and mineral content. These relationships appeared independent of those maternal factors known to be associated with neonatal bone mass, consistent with notion that such maternal influences might act through modulation of aspects of placental function, e.g. utero-placental blood flow or maternal nutrient concentrations, rather than placental size itself. Low placental volume early in pregnancy may be a marker of a reduced postnatal skeletal size and increased risk of later fracture.
Highlights
Osteoporosis is a major cause of morbidity and mortality through its association with age-related fractures
We have previously demonstrated that the expression of a placental calcium transporter (PMCA3) gene predicts neonatal bone mineral content [9], but it remains unclear whether the maternal influences described act on fetal bone development via placental size or function
In this study we investigate the relationships between placental dimensions, measured by ultrasound scanning, and offspring body composition, bone size and density assessed by dual x-ray absorptiometry (DXA) at birth, using a longitudinal populationbased mother-offspring cohort, the Southampton Women’s Survey (SWS)
Summary
Osteoporosis is a major cause of morbidity and mortality through its association with age-related fractures. We have previously demonstrated that growth in utero and early childhood predict adult bone mineral content (BMC) [2,3] and risk of hip fracture in. Doi:10.1016/j.placenta.2012.04.007 later life [4] Maternal factors such as smoking, body build, physical activity, diet [5] and circulating 25(OH) vitamin D status [6] during pregnancy are associated with offspring bone mineral accrual. During the period of a normal human pregnancy the fetus accumulates approximately 30 g of calcium [7] This fetal demand is met through placental calcium transport, which results in a higher calcium concentration in fetal than maternal blood [8]. We have previously demonstrated that the expression of a placental calcium transporter (PMCA3) gene predicts neonatal bone mineral content [9], but it remains unclear whether the maternal influences described act on fetal bone development via placental size or function
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