Perinatal Disorders and Small Birthweight Are Significantly Associated With Small Vertebral Neural Canal Size in a Contemporary Pediatric Autopsy Sample

Abstract

Study design: A retrospective, nonblinded, single-center observational study.

Objective: The purpose of this study is to examine associations between small vertebral neural canal (VNC) measurements with verified experiences of early-life stress (ELS) (premature birth, disorders or conditions arising in the perinatal period, and congenital disorders) in a pediatric autopsy sample, paired with other skeletal indicators of stress, and known demographic/health information.

Summary of background data: Most studies linking small VNC size to ELS are for human remains from archeological sites without known demographic information or health history, making it difficult to assess what kind of stress might affect VNC growth.

Methods: This is a single-center retrospective study in a pediatric autopsy sample of 623 individuals (aged 0.5 to 20.9 yr) with known sex, age, and manner of death (MOD), who died between 2011 and 2019. Data were collected from postmortem computed tomography scans, autopsy, and field investigator reports. Data include VNC anteroposterior and transverse (TR) diameters of the 12th thoracic (T12) and fifth lumbar (L5) vertebrae, bone mineral density, and Harris lines.

Results: Small birthweight males have significantly smaller VNC than those with an average birthweight. The natural MOD is associated with smaller VNC. Perinatal disorders and growth stunting are associated with smaller T12 anteroposterior, T12-TR, and L5-TR diameters. Congenital disorders and Harris lines are not associated with small VNC.

Conclusions: Reduced VNC size is a reliable indicator of severe ELS, but not all ELS leads to reduced VNC. Females appear less susceptible to perinatal environmental stress than males. Reduced VNC may also be indicative of heightened risk of disease and death in those who died of natural MOD.

Level of evidence: Level 2.