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Pediatr Res. 2020 Jan 22. doi: 10.1038/s41390-020-0771-3. [Epub ahead of print]

Preterm birth and the future risk of orthopedic fracture.

Author information

1
Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada.
2
Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, Canada.
3
Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Canada.
4
Department of Pediatrics, Sainte-Justine Hospital Centre, University of Montreal, Montreal, Canada.
5
Departments of Pediatrics, Psychiatry, and Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
6
Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada. nathalie.auger@inspq.qc.ca.
7
Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, Canada. nathalie.auger@inspq.qc.ca.
8
Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Canada. nathalie.auger@inspq.qc.ca.

Abstract

BACKGROUND:

Preterm birth occurs during a critical period of bone mineralization. We assessed whether preterm birth increases the risk of childhood fracture.

METHODS:

We analyzed a cohort of 788,903 infants born between 2006 and 2016 in Quebec, Canada. The exposure was preterm birth (<37 weeks). The outcome was any future hospitalization for fracture before 2018. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association of prematurity with fractures in adjusted Cox regression models. We determined if the risk of facture varied by the child's age.

RESULTS:

The incidence of fracture hospitalizations was higher in preterm children than in term children (17.9 vs. 15.3 per 10,000 person-years). Compared with term, preterm children had 1.27 times the risk of femur fracture hospitalization (95% CI 1.01-1.60) and 2.27 times the risk of assault-related fractures (95% CI 1.37-3.76). Preterm children had 2.20 times the risk of femur fracture between 6 and 17 months of age (95% CI 1.45-3.35).

CONCLUSIONS:

Preterm birth is associated with an increased risk of hospitalization for femur fractures and assault-related fractures. Associations are stronger before 18 months of age. Families of preterm children may benefit from counseling and support for fracture prevention during early childhood.

PMID:
31968355
DOI:
10.1038/s41390-020-0771-3

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