Birth weight and adult bone mass: A systematic literature review

Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Osteoporosis International (Impact Factor: 4.17). 12/2010; 21(12):1981-91. DOI: 10.1007/s00198-010-1236-z
Source: PubMed


This systematic literature review comprised 16 studies. The association of birth weight with bone parameters was much more evident for bone mineral content (BMC) rather than bone mineral density (BMD). This is an important finding since a reduction in BMC is strongly associated with an increased risk of fractures.
The purpose of this study was to conduct a systematic literature review of studies that have investigated the association between birth weight (BW) and adult bone mass.
The search included English language articles, indexed in MEDLINE, using the key words: ("birth size" OR "birth weight" OR birthweight) AND (osteoporosis OR "bone mass" OR "bone density" OR "bone mineral density" OR "bone mineral content" OR "bone area"). A methodological quality appraisal of the reviewed studies was performed.
Sixteen articles were reviewed. Eleven of 13 studies that measured BMC verified a positive effect of BW on this parameter, and nine even after adjustment for adult body size. Among the ten studies that found an unadjusted association between BW and BMD, two reported that the significance remained after adjustment for current body size. Interaction between prenatal and postnatal variables on the determination of adult bone mass was only tested by two studies. The results must be interpreted with caution due to the existence of few papers on the issue, as well as heterogeneous sample characteristics, investigated bone sites, and implemented analysis procedures. The aspects of methodological quality that frequently fail are as follows: representativeness of the planned and actually measured sample as well as proper adjustment for confounding.
Based on the amount of accumulated evidence, it is probable that BW have a positive association with adult BMC rather than BMD, which is an important finding for clinical and public health policies since a reduction in BMC is strongly associated with an increased fracture risk.

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    • "El Hage R (2010) Birth weight is an independent determinant of whole body bone mineral content and bone mineral density in a group of Lebanese adolescent girls. J Bone Miner Metab 28 (3):360–363 39. Schlussel MM et al (2010) Birth weight and bone mass in young adults from Brazil. Bone 46(4):957–963 40. "
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    ABSTRACT: Lower birth weight has a negative association with adult BMC and body composition in young adult Swedish women. INTRODUCTION: The aim of this study was to evaluate the influence of birth weight on peak bone mass and body composition in a cohort of 25-year-old women. METHODS: One thousand sixty-one women participated in this cross-sectional population-based study using dual energy X-ray absorptiometry (DXA) to assess bone mineral content (BMC), bone mineral density (BMD), and body composition (total body (TB), femoral neck (FN), total hip (TH), lumbar spine L1-L4 (LS), and lean and fat mass). Birth weight data was available for 1,047 women and was categorized into tertiles of low (≤3,180 g), intermediate (3,181-3,620 g), and high (≥3,621 g) birth weight. RESULTS: Significant correlations were observed between birth weight and TB-BMC (r = 0.159, p < 0.001), FN-BMC (r = 0.096, p < 0.001), TH-BMC (r = 0.102, p = 0.001), LS-BMC (r = 0.095, p = 0.002), and lean mass (r = 0.215, p < 0.001). No correlation was observed between birth weight and BMD. The estimated magnitude of effect was equivalent to a 0.3-0.5 SD difference in BMC for every 1 kg difference in birth weight (151 g (TB); 0.22 g (FN); 1.5 g (TH), 2.5 kg TB lean mass). The strongest correlations between birth weight and BMC occurred in women with lowest birth weights, although excluding women who weighed <2,500 g at birth, and the correlation remained significant although slightly weaker. CONCLUSIONS: Women with lower birth weight have lower BMC and less lean and fat mass at the age of 25, independent of current body weight. Lower birth weight has a greater negative influence on bone mass than the positive influence of higher birth weight.
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