{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:54:48Z","timestamp":1790769288413,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim is to test whether a fraction of full\u2010term infants pass through a phase of postnatal fracture susceptibility and whether this physiological phase explains real\u2010world fracture age distributions in young infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Preterm infant data were used to establish fracture risk zones based on bone quality (using Speed of Sound, SOS) and metabolic activity (Alkaline Phosphatase, ALP) levels. These reference thresholds were applied to a full\u2010term cohort to identify clinical overlap. Age distributions of full\u2010term infants within risk zones were evaluated alongside paediatric fracture data from the KID Inpatient Database and data concerning rib fractures from cardiopulmonary resuscitation (CPR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The low\u2010SOS and high\u2010ALP tails of the full\u2010term population overlap with risk zones for metabolic bone disease of prematurity (MBDP) during the post\u2010birth trough in bone mineralisation. The log\u2010normal age distributions of full\u2010term infants in these risk zones are indicative of a developmental phase and share the morphology and peak timing of infant rib and multiple fractures, whether registered as abuse, accidental, or CPR\u2010related.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The synchronisation of fracture peaks with the physiological trough of infant bone quality supports Developmental Osteopenia as an explanatory framework for rib and multiple fractures in young infancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70778","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:59:03Z","timestamp":1790765943000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Developmental Osteopenia: An Explanation for Fractures in Young Infants"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0534-4115","authenticated-orcid":false,"given":"Chris","family":"Brook","sequence":"first","affiliation":[{"name":"Universidad de La Laguna  San Crist\u00f3bal de La Laguna Spain"},{"name":"School of Law Griffith University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Mack","sequence":"additional","affiliation":[{"name":"Pennsylvania State University  University Park USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waney","family":"Squier","sequence":"additional","affiliation":[{"name":"Previously Department of Neuropathology John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2025.1676540","article-title":"Metabolic Bone Disease in Extremely Preterm Infants: Incidence, Risk Factors, and Outcomes From a Structured Bone Health Program","volume":"13","author":"Alsaif S.","year":"2025","journal-title":"Frontiers in Pediatrics"},{"issue":"1","key":"e_1_2_12_3_1","first-page":"S35","article-title":"Nutritional Needs of Premature Infants: Current Issues","volume":"43","author":"Rigo J.","year":"2006","journal-title":"Journal of Pediatric Gastroenterology and Nutrition"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.5409\/wjcp.v12.i1.1"},{"key":"e_1_2_12_5_1","first-page":"1202","volume-title":"Fanaroff and Martin's Neonatal\u2010Perinatal Medicine","author":"Abrams S. 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