Quantitative ultrasound and biochemical parameters for the assessment of osteopenia in preterm infants

J Matern Fetal Neonatal Med. 2007 May;20(5):401-5. doi: 10.1080/14767050701287418.


Objective: Our study aimed to evaluate the feasibility of quantitative ultrasound (QUS) evaluation in osteopenia of prematurity and to compare the results to biochemical parameters.

Methods: QUS assessment of bone was performed at the end of the first postnatal week and at term-corrected age (CA) in premature infants (N = 30) and within the first week in full-term infants (N = 25). On the same day of measurement of QUS, the serum calcium, phosphorus (inorganic), and alkaline phosphatase (ALP) activity were measured in the preterm infants.

Results: The median of tibia z score at term-CA in premature infants was significantly lower compared to that of first postnatal week (-1 and 0.4, respectively; p < 0.0001) and it was also lower than that of term-matched controls (0.0; p = 0.001). Preterm infants at term-CA had lower weights and lengths in comparison to term infants. The median ALP value was 585 IU/L at the first postnatal week and 703 IU/L at term-CA in preterm infants (p = 0.003). The median tibia z score of infants with ALP >or=900 IU/L was significantly lower than that of the infants with ALP <900 IU/L (-1.4 vs. 0.1; p = 0.001). An inverse correlation was found between ALP levels and tibia z score at term-CA in preterm infants (rho = -0.61, p = 0.01).

Conclusions: Bone density of preterm infants at term-CA was lower than that at first postnatal week. Serum ALP levels increased during the first postnatal weeks. The tibia z scores were correlated to serum ALP levels. QUS is a good screening tool for the detection of osteopenia.

Publication types

  • Comparative Study

MeSH terms

  • Alkaline Phosphatase / blood
  • Bone Density
  • Bone Diseases, Metabolic / blood*
  • Bone Diseases, Metabolic / diagnostic imaging*
  • Calcium / blood
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / blood*
  • Infant, Premature, Diseases / diagnostic imaging*
  • Male
  • Phosphorus / blood
  • Tibia / diagnostic imaging
  • Ultrasonography


  • Phosphorus
  • Alkaline Phosphatase
  • Calcium