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

Anastasia Pavlova; Janet E. Jeffrey; Rebecca J. Barr; Richard M. Aspden

doi:10.1111/joa.13024

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

Anastasia Pavlova, Janet E. Jeffrey, Rebecca J. Barr, Richard M. Aspden^* (Corresponding Author)

^*Corresponding author for this work

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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 10 years 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.

Original language	English
Pages (from-to)	749-756
Number of pages	8
Journal	Journal of Anatomy
Volume	235
Issue number	4
Early online date	20 Jun 2019
DOIs	https://doi.org/10.1111/joa.13024
Publication status	Published - Oct 2019

Bibliographical note

Acknowledgements
Ethical approval for this study was granted by the North of Scotland Research Ethics Committees (13/NS/0162). We would like to thank the authors and radiographers and participants involved in the original study from which MR images and data were used. We thank Dr Onyedikachi Eseonu for his contribution to data generation and marking up spinal images. AVP was supported by a PhD studentship kindly donated by Roemex Ltd. to the Aberdeen Centre of the Oliver Bird Rheumatism Programme at the Nuffield Foundation. The funders played no part in the design, execution or publication of this study and the authors have no interests to declare

Keywords

lumbar spine
perinatal factors
antenatal
lordosis
statistical shape modelling
SAGITTAL ALIGNMENT
RISK-FACTORS
LOW-BIRTH-WEIGHT
HIP
BALANCE
SPINAL CURVATURE
FRACTURE
MODELS
DISC DEGENERATION
MORPHOLOGY

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10.1111/joa.13024Licence: Unspecified

Accepted Manuscript
This is the peer reviewed version of the following article: Pavlova, A. V., Jeffrey, J. E., Barr, R. J. and Aspden, R. M. (2019), Perinatal factors associate with vertebral size and shape but not lumbar lordosis in 10‐year‐old children. J. Anat., 235: 749-756., which has been published in final form at https://doi.org/10.1111/joa.13024. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Accepted author manuscript, 804 KBLicence: Unspecified
Supporting informationAccepted author manuscript, 161 KBLicence: Unspecified

Cite this

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title = "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 10 years 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.",

keywords = "lumbar spine, perinatal factors, antenatal, lordosis, statistical shape modelling, SAGITTAL ALIGNMENT, RISK-FACTORS, LOW-BIRTH-WEIGHT, HIP, BALANCE, SPINAL CURVATURE, FRACTURE, MODELS, DISC DEGENERATION, MORPHOLOGY",

author = "Anastasia Pavlova and Jeffrey, {Janet E.} and Barr, {Rebecca J.} and Aspden, {Richard M.}",

note = "Acknowledgements Ethical approval for this study was granted by the North of Scotland Research Ethics Committees (13/NS/0162). We would like to thank the authors and radiographers and participants involved in the original study from which MR images and data were used. We thank Dr Onyedikachi Eseonu for his contribution to data generation and marking up spinal images. AVP was supported by a PhD studentship kindly donated by Roemex Ltd. to the Aberdeen Centre of the Oliver Bird Rheumatism Programme at the Nuffield Foundation. The funders played no part in the design, execution or publication of this study and the authors have no interests to declare",

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N1 - Acknowledgements Ethical approval for this study was granted by the North of Scotland Research Ethics Committees (13/NS/0162). We would like to thank the authors and radiographers and participants involved in the original study from which MR images and data were used. We thank Dr Onyedikachi Eseonu for his contribution to data generation and marking up spinal images. AVP was supported by a PhD studentship kindly donated by Roemex Ltd. to the Aberdeen Centre of the Oliver Bird Rheumatism Programme at the Nuffield Foundation. The funders played no part in the design, execution or publication of this study and the authors have no interests to declare

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N2 - 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 10 years 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.

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KW - MODELS

KW - DISC DEGENERATION

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

Abstract

Bibliographical note

Keywords

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