Perinatal factors associate with vertebral size and shape but not lumbar lordosis in 10-year-old children

Anastasia Pavlova, Janet E. Jeffrey, Rebecca J. Barr, Richard M. Aspden* (Corresponding Author)

*Corresponding author for this work

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The intrauterine environment is known to influence foetal development and future health. Low birthweight has been linked to smaller vertebral canals in children and decreased adulthood spine bone mineral content. Perinatal factors affecting lumbar spine curvature have not yet been considered but could be important for adult spinal health, as lumbar movement during lifting, a risk factor for backpain, is associated with lordosis. To investigate this, lumbar spine magnetic resonance images at age 10 years and perinatal and maternal data (birthweight, placental weight, gestation length, crown‐heel length, maternal age, height, weight and smoking status) from 161 children born in Aberdeen in 1988–1989 were acquired. Statistical shape modelling, using principal component analysis, quantified variations in lumbar spine shape and resulting modes of variation were assessed in combination with perinatal data using correlations and analyses of covariance, adjusted for potential confounders. Spine modes 1–3 (SM1–SM3) captured 75% of the variation in lumbar spine shape. The first and third modes described the total amount (SM1) and evenness of curvature distribution (SM3). SM2 accounted for variations in antero‐posterior vertebral diameter relative to vertebral height, increasing positive scores representing a larger relative diameter. Adjusting for gestation length and sex, SM2 positively correlated with birthweight (= 0.25, < 0.01), placental weight (= 0.20, = 0.04), crown‐heel length (= 0.36, < 0.001) and maternal weight (= 0.19, = 0.04), and negatively with maternal age (= −0.22, = 0.02). SM2 scores were lower in girls (< 0.001) and in the low birthweight group (= 0.02). There were no significant differences in SM1 and SM3 scores between birthweight groups, boys and girls or children of smokers (31%) and non‐smokers (69%). In conclusion, some perinatal factors were associated with vertebral body morphology but had little effect on lumbar curvature.
Original languageEnglish
Pages (from-to)749-756
Number of pages8
JournalJournal of Anatomy
Issue number4
Early online date20 Jun 2019
Publication statusPublished - Oct 2019

Bibliographical note

Ethical approval for this study was granted by the North of Scotland Research Ethics Committees (13/NS/0162). We would like to thank the authors and radiographers and participants involved in the original study from which MR images and data were used. We thank Dr Onyedikachi Eseonu for his contribution to data generation and marking up spinal images. AVP was supported by a PhD studentship kindly donated by Roemex Ltd. to the Aberdeen Centre of the Oliver Bird Rheumatism Programme at the Nuffield Foundation. The funders played no part in the design, execution or publication of this study and the authors have no interests to declare


  • lumbar spine
  • perinatal factors
  • antenatal
  • lordosis
  • statistical shape modelling
  • HIP


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