Bone status in the neonatal period has an important impact on skeletal development in later life. By evaluating bone status, it is possible to determine bone nutrient status and to prevent and treat metabolic bone diseases. Currently, the diagnosis of metabolic bone disease is mainly based on biochemical markers and radiology. Biochemical markers do not have a significant correlation with Bone Mineral Density (BMD). Dual-energy X-ray Absorptiometry (DXA) has not been tested extensively in preterm infants. Quantitative Ultrasound (QUS) has been developed in the last 20 years as a non-invasive, portable, inexpensive and radiation-free technique. For cancellous bone, Broadband Ultrasound Attenuation (BUA) and the Speed of Sound (SOS) based on ultrasonic transmission method are the most commonly used parameters for QUS. However, ultrasonic transmission measurement has some limitations. Therefore, a strong interest has developed in alternative quantitative ultrasound approaches.
The objective of this study was to assess the value of ultrasonic backscatter signals and the Backscatter Coefficient (BSC) for the analysis of bone status in neonates and to analyze the relationships between the BSC and gestational age, birthweight, length, head circumference and gender. A total of 122 neonates participated in the study, including 83 premature infants and 39 full-term infants. Their BSCs were measured by ultrasound after birth. The results showed a significant correlation between the BSC and gestational age (R=0.47, p<0.001), birthweight (R=0.47, p<0.0001) and length at birth (R=0.43, p<0.001) at a frequency of 5.0 MHz. This study suggests that the use of ultrasonic backscatter signals and the BSC is feasible for assessing the bone status of neonates. Further study is required to establish a database of normative BSC data in neonates in order to monitor the bone status of newborns, especially preterm infants, who are at high risk of osteopenia.