1. Objectifs

Intentions :
The authors «sought to determine the relationship between prematurity and risk of orthopedic fracture in childhood using a large population-based cohort of infants.» (p. 1)

2. Méthode

Échantillon/Matériau :
They «analyzed a longitudinal cohort of 788,903 neonates born ˃22 weeks’ gestation in hospitals of Quebec, Canada between 2006 and 2016. The cohort included 51,212 preterm births defined as <37 weeks’ gestation.» (p. 1)

Type de traitement des données :
Analyse statistique

3. Résumé

«In this study, [the authors] found an association between preterm birth and risk of fracture hospitalization in the first 18 months of life, but no significant relationship thereafter. The associations were stronger for assault-related fractures and varied by site. Overall, the findings suggest that metabolic bone disorders do not account for a substantial proportion of fractures among preterm infants, and that psychosocial factors may be more important.» (p. 6) «Nearly 80% of fractures due to child maltreatment occur before 18 months of age. Accidental fractures due to falls can occur before 18 months, but are still suspicious for maltreatment, as children within this age range are not yet walking and do not normally fall with enough energy to cause fracture. […] Preterm infants may be at risk of child maltreatment for several reasons. Risk factors for preterm birth, such as low maternal education, stress, and drug use are linked with an increased risk of child maltreatment. Preterm children are more likely than term children to have special needs, and may have poorly regulated behaviors or difficult temperament making interactions challenging. Risk of maltreatment may be greater if there is low parental attachment in conjunction with risk factors such as low socioeconomic status.» (p. 6)