Received: 25 October 2017 / Revised: 8 January 2018 /Accepted: 9 January 2018 / Published online: 19 January 2018
Springer-Verlag GmbH Germany, part of Springer Nature 2018
We hypothesised that extremely premature infants would have decreased muscle mass at term-corrected age com-
pared to term-born infants and that the degree of reduced muscle mass acquisition would correlate with the duration
of invasive mechanical ventilation. The MRI brain scans of infants admitted in the neonatal unit at King’s College
Hospital between 1 January 2010 and 1 June 2016 were retrospectively reviewed. The coronal cross-sectional area of
the left deltoid muscle (DCSA) was measured in 17 infants born < 28 weeks of gestation and in 20 infants born at
term. The prematurely born infants had a median (IQR) gestation age of 25 weeks (24–27) and the term infants
40 weeks (38–41). The duration of invasive mechanical ventilation for the prematurely born infants was 39 days
(14–62) and that for the term infants 4 days (2–5), p < 0.001. DCSA was smaller in prematurely born infants
(median 189, IQR 176–223 mm
) compared to term-born infants (median 302, IQR 236–389 mm
), p < 0.001.
DCSA was related to gestation age (r =0.545, p = 0.001), weight z-score at MRI (r = 0.658, p < 0.001) and days of
invasive mechanical ventilation (r = − 0.583, p < 0.001). In conclusion, extremely premature infants studied at term
had a lower muscle mass compared to term-born infants.
Conclusion: Our results suggest that prolonged mechanical ventilation in infants admitted in neonatal intensive care is
associated with reduced skeletal muscle mass acquisition.
What is Known:
• Prolonged mechanical ventilation in adult intensive care patients has been associated with skeletal muscle dysfunction and atrophy.
• The cross-sectional area of the deltoid muscle has been used to evaluate muscle atrophy in infants with a previous branchial plexus birth injury.
What is New:
• Premature infants studied at term exhibit lower cross-sectional area of the deltoid muscle than their term counterparts.
• Prolonged mechanical ventilation could be associated with skeletal muscle impairment.
Keywords Deltoid muscle morphometry
Impaired skeletal muscularity
Neonatal intensive care
Communicated by Patrick Van Reempts
* Anne Greenough
Neonatal Intensive Care Centre, King’s College Hospital NHS
Foundation Trust, London, UK
European Journal of Pediatrics (2018) 177:507–512
Deltoid muscle morphometry as an index of impaired skeletal
muscularity in neonatal intensive care
MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King’s
College London, 4th Floor Golden Jubilee Wing, King’sCollege
Hospital, Denmark Hill, London SE5 9RS, UK
Women and Children’s Health, School of Life Course Sciences,
Faculty of Life Sciences and Medicine, King’s College London,
Department of Radiology, Cambridge University Hospitals NHS
Foundation Trust, Cambridge, UK
National Institute for Health Research (NIHR) Biomedical Research
Centre based at Guy’sandStThomas’ NHS Foundation Trust and
King’s College London, London, UK