Skip to main content
Top
Published in: Osteoporosis International 11/2009

Open Access 01-11-2009 | Original Article

The role of early life variables on the risk of fractures from birth to early adolescence: a prospective birth cohort study

Authors: P. C. Hallal, F. V. Siqueira, A. M. B. Menezes, C. L. P. Araújo, S. A. Norris, C. G. Victora

Published in: Osteoporosis International | Issue 11/2009

Login to get access

Abstract

Summary

In a prospective cohort from Brazil, we evaluated the incidence of fractures from birth to early adolescence and examined risk factors for fractures. The incidence was 14.2% (95%CI 13.2, 15.2). Male sex, birth length, and maternal age at delivery were positively associated with the risk of fractures.

Introduction

This study aims to evaluate the incidence of fractures from birth to 11 years of age and to explore the effect of early life variables on the risk of fractures.

Methods

All children (N = 5,249) born in 1993 in the city of Pelotas, Brazil were enrolled in a prospective birth cohort study. In 2004–2005, 87.5% of the cohort members were sought for a follow-up visit. History of fractures, including anatomic site and age of the fracture were asked to mothers.

Results

The incidence of fractures from birth to 11 years of age was 14.2% (95%CI 13.2, 15.2). Out of the 628 subjects who experienced a fracture, 91 reported two and only 20 reported three or more fractures. Male sex, birth length, and maternal age at delivery were positively associated with the risk of fractures. No consistent associations were found for family income, maternal body mass index, smoking during pregnancy, and birth weight.

Conclusions

Birth length seems to have long-term effect on musculoskeletal health. The higher risk of fractures among children of older mothers needs to be confirmed by other studies. In accordance to the developmental origins of diseases, fractures seem to be, at least in part, programmed in early life.
Literature
1.
go back to reference Jones IE, Williams SM, Dow N, Goulding A (2002) How many children remain fracture-free during growth? A longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study. Osteoporos Int 13:990–995CrossRefPubMed Jones IE, Williams SM, Dow N, Goulding A (2002) How many children remain fracture-free during growth? A longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study. Osteoporos Int 13:990–995CrossRefPubMed
2.
go back to reference Kypri K, Chalmers DJ, Langley JD, Wright CS (2001) Child injury morbidity in New Zealand, 1987–1996. J Paediatr Child Health 37:227–234CrossRefPubMed Kypri K, Chalmers DJ, Langley JD, Wright CS (2001) Child injury morbidity in New Zealand, 1987–1996. J Paediatr Child Health 37:227–234CrossRefPubMed
3.
go back to reference Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Klag MJ (2000) Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Ann Intern Med 133:321–328PubMed Gelber AC, Hochberg MC, Mead LA, Wang NY, Wigley FM, Klag MJ (2000) Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Ann Intern Med 133:321–328PubMed
4.
go back to reference Yuan PS, Pring ME, Gaynor TP, Mubarak SJ, Newton PO (2004) Compartment syndrome following intramedullary fixation of pediatric forearm fractures. J Pediatr Orthop 24:370–375PubMed Yuan PS, Pring ME, Gaynor TP, Mubarak SJ, Newton PO (2004) Compartment syndrome following intramedullary fixation of pediatric forearm fractures. J Pediatr Orthop 24:370–375PubMed
5.
go back to reference Donaldson LJ, Cook A, Thomson RG (1990) Incidence of fractures in a geographically defined population. J Epidemiol Community Health 44:241–245CrossRefPubMed Donaldson LJ, Cook A, Thomson RG (1990) Incidence of fractures in a geographically defined population. J Epidemiol Community Health 44:241–245CrossRefPubMed
6.
go back to reference Heaney RP, Abrams S, Dawson-Hughes B, Looker A, Marcus R, Matkovic V, Weaver C (2000) Peak bone mass. Osteoporos Int 11:985–1009CrossRefPubMed Heaney RP, Abrams S, Dawson-Hughes B, Looker A, Marcus R, Matkovic V, Weaver C (2000) Peak bone mass. Osteoporos Int 11:985–1009CrossRefPubMed
7.
go back to reference Johansen A, Evans RJ, Stone MD, Richmond PW, Lo SV, Woodhouse KW (1997) Fracture incidence in England and Wales: a study based on the population of Cardiff. Injury 28:655–660CrossRefPubMed Johansen A, Evans RJ, Stone MD, Richmond PW, Lo SV, Woodhouse KW (1997) Fracture incidence in England and Wales: a study based on the population of Cardiff. Injury 28:655–660CrossRefPubMed
8.
go back to reference Jones IE, Williams SM, Goulding A (2004) Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study. Am J Epidemiol 159:343–350CrossRefPubMed Jones IE, Williams SM, Goulding A (2004) Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study. Am J Epidemiol 159:343–350CrossRefPubMed
9.
go back to reference Harpham T, Huttly S, Wilson I, de Wet T (2003) Linking public issues with private troubles: panel studies in developing countries. J Int Dev 15:353–363CrossRef Harpham T, Huttly S, Wilson I, de Wet T (2003) Linking public issues with private troubles: panel studies in developing countries. J Int Dev 15:353–363CrossRef
10.
go back to reference Victora CG, Hallal PC, Araujo CL, Menezes AM, Wells JC, Barros FC (2008) Cohort profile: the 1993 Pelotas (Brazil) birth cohort study. Int J epidemiol 37:704–709PubMed Victora CG, Hallal PC, Araujo CL, Menezes AM, Wells JC, Barros FC (2008) Cohort profile: the 1993 Pelotas (Brazil) birth cohort study. Int J epidemiol 37:704–709PubMed
11.
go back to reference Dubowitz L (1969) Assessment of gestational age in newborn: a practical scoring system. Arch Dis Child 44:782CrossRefPubMed Dubowitz L (1969) Assessment of gestational age in newborn: a practical scoring system. Arch Dis Child 44:782CrossRefPubMed
12.
go back to reference Victora CG, Huttly SR, Fuchs SC, Olinto MT (1997) The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J epidemiol 26:224–227CrossRefPubMed Victora CG, Huttly SR, Fuchs SC, Olinto MT (1997) The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J epidemiol 26:224–227CrossRefPubMed
13.
go back to reference Barker DJ (1990) The fetal and infant origins of adult disease. BMJ (Clinical research ed) 301:1111CrossRef Barker DJ (1990) The fetal and infant origins of adult disease. BMJ (Clinical research ed) 301:1111CrossRef
14.
go back to reference Swanson JD, Wadhwa PM (2008) Developmental origins of child mental health disorders. J Child Psychol Psychiatry Allied Discipl 49:1009–1019CrossRef Swanson JD, Wadhwa PM (2008) Developmental origins of child mental health disorders. J Child Psychol Psychiatry Allied Discipl 49:1009–1019CrossRef
15.
go back to reference Cooper C, Javaid MK, Taylor P, Walker-Bone K, Dennison E, Arden N (2002) The fetal origins of osteoporotic fracture. Calcif Tissue Int 70:391–394CrossRefPubMed Cooper C, Javaid MK, Taylor P, Walker-Bone K, Dennison E, Arden N (2002) The fetal origins of osteoporotic fracture. Calcif Tissue Int 70:391–394CrossRefPubMed
16.
go back to reference Jones G, Dwyer T (2000) Birth weight, birth length, and bone density in prepubertal children: evidence for an association that may be mediated by genetic factors. Calcif Tissue Int 67:304–308CrossRefPubMed Jones G, Dwyer T (2000) Birth weight, birth length, and bone density in prepubertal children: evidence for an association that may be mediated by genetic factors. Calcif Tissue Int 67:304–308CrossRefPubMed
17.
go back to reference Siqueira FV, Facchini LA, Hallal PC (2005) The burden of fractures in Brazil: a population-based study. Bone 37:261–266CrossRefPubMed Siqueira FV, Facchini LA, Hallal PC (2005) The burden of fractures in Brazil: a population-based study. Bone 37:261–266CrossRefPubMed
18.
go back to reference Clark EM, Ness AR, Bishop NJ, Tobias JH (2006) Association between bone mass and fractures in children: a prospective cohort study. J Bone Miner Res 21:1489–1495CrossRefPubMed Clark EM, Ness AR, Bishop NJ, Tobias JH (2006) Association between bone mass and fractures in children: a prospective cohort study. J Bone Miner Res 21:1489–1495CrossRefPubMed
19.
go back to reference Thandrayen K, Norris SA, Pettifor JM (2009) Fracture rates in urban South African children of different ethnic origins: the birth to twenty cohort. Osteoporos Int 20:47–52CrossRefPubMed Thandrayen K, Norris SA, Pettifor JM (2009) Fracture rates in urban South African children of different ethnic origins: the birth to twenty cohort. Osteoporos Int 20:47–52CrossRefPubMed
Metadata
Title
The role of early life variables on the risk of fractures from birth to early adolescence: a prospective birth cohort study
Authors
P. C. Hallal
F. V. Siqueira
A. M. B. Menezes
C. L. P. Araújo
S. A. Norris
C. G. Victora
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 11/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-009-0889-y

Other articles of this Issue 11/2009

Osteoporosis International 11/2009 Go to the issue