胎儿骨负荷是胎儿和婴儿骨强度的关键决定因素

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-04-09 DOI:10.1016/j.clinbiomech.2025.106513

Marvin Miller

{"title":"胎儿骨负荷是胎儿和婴儿骨强度的关键决定因素","authors":"Marvin Miller","doi":"10.1016/j.clinbiomech.2025.106513","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The Utah Paradigm is the contemporary model of bone physiology that allows for an understanding of risk factors for bone fragility and can be used in understanding infants who present with multiple unexplained fractures in contested cases of child abuse.</div></div><div><h3>Method</h3><div>The Utah Paradigm was applied to the fetal period in over 500 cases of contested child abuse cases in infants with multiple unexplained fractures to determine if risk factors for bone fragility could be identified.</div></div><div><h3>Findings</h3><div>Multiple risk factors for fetal bone fragility were identified: inadequate provision by the mother during pregnancy of essential bone nutrients (calcium, phosphate, vitamin D, and protein), prematurity, gestational diabetes, and fetal exposure to drugs that can affect bone strength. The most common risk factor was decreased fetal bone loading from decreased fetal movement. More than one risk factor was often identified in these cases, and the term Metabolic Bone Disease of Infancy is used to describe this multifactorial bone fragility disorder of young infants. Infants with Metabolic Bone Disease of Infancy have X-rays that show poor bone mineralization, and this condition can be misdiagnosed as child abuse.</div></div><div><h3>Interpretation</h3><div>Metabolic Bone Disease of Infancy should be considered in infants with multiple unexplained fractures. This condition can be established by finding abnormal X-rays showing poor bone mineralization and risk factors for bone fragility. Fetal bone loading is the most critical determinant of fetal and young infant bone strength. Situations that cause decreased fetal movement can casue decreased fetal and young infant bone strength.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106513"},"PeriodicalIF":1.4000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fetal bone loading is a critical determinant of fetal and young infant bone strength\",\"authors\":\"Marvin Miller\",\"doi\":\"10.1016/j.clinbiomech.2025.106513\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The Utah Paradigm is the contemporary model of bone physiology that allows for an understanding of risk factors for bone fragility and can be used in understanding infants who present with multiple unexplained fractures in contested cases of child abuse.</div></div><div><h3>Method</h3><div>The Utah Paradigm was applied to the fetal period in over 500 cases of contested child abuse cases in infants with multiple unexplained fractures to determine if risk factors for bone fragility could be identified.</div></div><div><h3>Findings</h3><div>Multiple risk factors for fetal bone fragility were identified: inadequate provision by the mother during pregnancy of essential bone nutrients (calcium, phosphate, vitamin D, and protein), prematurity, gestational diabetes, and fetal exposure to drugs that can affect bone strength. The most common risk factor was decreased fetal bone loading from decreased fetal movement. More than one risk factor was often identified in these cases, and the term Metabolic Bone Disease of Infancy is used to describe this multifactorial bone fragility disorder of young infants. Infants with Metabolic Bone Disease of Infancy have X-rays that show poor bone mineralization, and this condition can be misdiagnosed as child abuse.</div></div><div><h3>Interpretation</h3><div>Metabolic Bone Disease of Infancy should be considered in infants with multiple unexplained fractures. This condition can be established by finding abnormal X-rays showing poor bone mineralization and risk factors for bone fragility. Fetal bone loading is the most critical determinant of fetal and young infant bone strength. Situations that cause decreased fetal movement can casue decreased fetal and young infant bone strength.</div></div>\",\"PeriodicalId\":50992,\"journal\":{\"name\":\"Clinical Biomechanics\",\"volume\":\"125 \",\"pages\":\"Article 106513\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Biomechanics\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0268003325000865\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003325000865","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

摘要

背景犹他范式是当代的骨生理学模型，可用于了解骨脆性的风险因素，并可用于了解在有争议的虐童案件中出现多发性不明原因骨折的婴儿。研究结果发现，胎儿骨质脆弱的风险因素有多种：母亲在怀孕期间没有提供足够的必要骨骼营养（钙、磷酸盐、维生素 D 和蛋白质）、早产、妊娠糖尿病以及胎儿接触会影响骨强度的药物。最常见的风险因素是胎动减少导致胎儿骨负荷降低。在这些病例中，通常会发现不止一个风险因素，因此婴儿代谢性骨病（Metabolic Bone Disease of Infancy）一词被用来描述这种多因素导致的幼儿骨质脆弱疾病。患有婴幼儿代谢性骨病的婴儿的 X 光片显示骨矿化不良，这种情况可能会被误诊为虐待儿童。如果发现异常的 X 光片显示骨矿化不良和存在骨脆性的危险因素，就可以确定这种疾病。胎儿骨骼负荷是决定胎儿和婴儿骨骼强度的最关键因素。导致胎动减少的情况会引起胎儿和婴儿骨强度下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Fetal bone loading is a critical determinant of fetal and young infant bone strength

Background

The Utah Paradigm is the contemporary model of bone physiology that allows for an understanding of risk factors for bone fragility and can be used in understanding infants who present with multiple unexplained fractures in contested cases of child abuse.

Method

The Utah Paradigm was applied to the fetal period in over 500 cases of contested child abuse cases in infants with multiple unexplained fractures to determine if risk factors for bone fragility could be identified.

Findings

Multiple risk factors for fetal bone fragility were identified: inadequate provision by the mother during pregnancy of essential bone nutrients (calcium, phosphate, vitamin D, and protein), prematurity, gestational diabetes, and fetal exposure to drugs that can affect bone strength. The most common risk factor was decreased fetal bone loading from decreased fetal movement. More than one risk factor was often identified in these cases, and the term Metabolic Bone Disease of Infancy is used to describe this multifactorial bone fragility disorder of young infants. Infants with Metabolic Bone Disease of Infancy have X-rays that show poor bone mineralization, and this condition can be misdiagnosed as child abuse.

Interpretation

Metabolic Bone Disease of Infancy should be considered in infants with multiple unexplained fractures. This condition can be established by finding abnormal X-rays showing poor bone mineralization and risk factors for bone fragility. Fetal bone loading is the most critical determinant of fetal and young infant bone strength. Situations that cause decreased fetal movement can casue decreased fetal and young infant bone strength.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.