New scanner to detect fragile bones in premature babies

Many premature babies have weak bones, putting them at risk of suffering fractures. Researchers are developing a new ultrasound scanner, which could allow screening of premature babies’ bones to become routine, for the first time ever. By enabling doctors to identify and treat the right babies, the scanner could help prevent fractures and may even bring about improvements in bone health that continue into adulthood.

What's the problem and who does it affect?

Premature babies at risk of fractures

A recent study suggests one in ten babies who weigh less than 1,500g (3lb 5oz) at birth suffer a fracture on the neonatal unit because they have weak bones.[1]

Some suffer fractures after they’ve left hospital and gone home, even though they seem perfectly healthy in every other way. Parents can become so anxious they worry that even a simple cuddle might harm their baby.

As well as putting babies at risk of fractures, weak bones at birth can lead to deformities in the shape of bones and breathing difficulties. Evidence suggests they might even have much longer term effects, possibly slowing growth through childhood and increasing the chance of developing osteoporosis later in life.

Simple steps, such as a diet rich in calcium and vitamin D, oral phosphate supplements and weight-bearing exercise can help build bone strength at young ages.

But it is very difficult to tell which babies need treatment, because there is no accurate and reliable way to screen their bones. X-ray scanners are sometimes used, but their size and immobility, the long scan time and the potential side-effects of exposure to x-rays make them unsuitable for routine use with premature babies.

What is the project trying to achieve?

Aiming for a world’s first

The aim of this project is to develop the world’s first ultrasound scanner that can provide 3D images of a newborn baby’s central skeleton and assess their bone health.

First, the researchers are designing, building and calibrating the new scanner, which will be housed within a shallow water bath. Babies will lie in the bath on a flexible mesh hammock, slightly under the water level. This ingenious set-up should minimise discomfort for the baby and overcome technical difficulties that arise when ultrasound comes into contact with air.

Then, the researchers will validate the scanner’s performance by using it to assess the bone health of around 400 newborns. Most will have been born at full-term, but some will be premature, and they will all take part in the study with their parents’ consent. Researchers will also compare the ultrasound scanner with other techniques, such as x-ray scanning.

What are the researchers' credentials?

This study brings together two internationally renowned researchers. Professor Christian Langton’s development of a revolutionary technique called heel ultrasound, for the assessment of osteoporosis, has been recognised as one of the top ‘100 discoveries and developments in UK Universities that have changed the world’ over the past 50 years, covering everything from the arts and humanities to science and technology.

Dr Ahmed is an experienced consultant who uses leading-edge techniques to care for newborn babies. He has extensive expertise in using ultrasound to assess the skeleton of newborns.

Who stands to benefit from this research and how?

Could routine screening help prevent fractures?

Researchers believe the new ultrasound scanner could allow routine screening of the bone health of premature babies, for the first time ever. By enabling doctors to identify and treat babies who have particularly weak bones, the scanner may help stop babies from suffering fractures and could possibly even improve their long-term bone health right into adulthood.

The researchers believe the new ultrasound technique is likely to be safe, easily accessible, low cost and quick, causing minimal disruption to the care of the baby. It will not use ionising radiation, such as x-rays, the equipment should be easy to position alongside the baby’s cot or incubator, and the scanning process will probably take just 20 seconds or so.

If it’s successful, researchers believe that the new ultrasound scanning technique could in the future be modified to help monitor the development of an unborn baby’s skeleton during pregnancy, and perhaps even to assess the bone health of children and adults.

References

1. Secondary prevention of osteoporotic fragility fractures in postmenopausal women – Appraisal Consultation Document. London: National Institute for Clinical Excellence, May 2004
[back to main article]