Original ArticlesLongitudinal Regional Brain Development and Clinical Risk Factors in Extremely Preterm Infants
Section snippets
Methods
Between June 2008 and March 2013, all preterm infants with gestational age <28 weeks admitted to the level-3 neonatal intensive care unit of the Wilhelmina Children's Hospital were consecutively enrolled in a prospective neuroimaging study. According to clinical protocol, infants were scanned twice, first at around 30 weeks gestation (range, 28.7-33.1 weeks), if clinically stable, and again at around TEA (range, 39.3-43.7 weeks). Infants with congenital anomalies, including chromosomal
Results
Clinical characteristics of the included infants are summarized in Table I (available at www.jpeds.com). We included 131 infants with data for both the 30-week and TEA MRI (serial scans), and an additional 79 infants with data only for the TEA MRI. The infants with serial scans had lower rates of pulmonary problems and sepsis, because they needed to be clinically stable to be eligible for the earlier scan.
Discussion
This study investigated the growth of 50 brain structures in an unselected cohort of extremely preterm infants using automatic segmentation. Our work has yielded detailed information about growth in this crucial period of brain development. Sex, BWZ, prolonged mechanical ventilation, and surgery showed global effects on the brain, whereas BI had a more localized effect, with enlarged ventricles and a smaller cerebellum.
To date, only a few small studies have reported neonatal serial volumetric
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2020, Journal of PediatricsCitation Excerpt :Although several clinical studies have shown the negative impact of respiratory illness on total brain growth at term,14,15,35 there is a paucity of research regarding brainstem volume in the neonates born preterm. Consistent with the findings from 2 other groups,48,49 we demonstrated that the duration of mechanical ventilation was strongly associated with the brainstem size at term age. Importantly, smaller pons or medulla at term age correlated with lower motor scores at preschool age.
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2020, Journal of PediatricsCitation Excerpt :Similarly, a recently published study did not show associations between nutritional intake in the first 28 days and brain volumes at TEA.34 After 30 weeks PMA, non-nutritional factors such as surgery or lung disease, might influence volumetric brain growth.35 Future studies should evaluate the effect of nutritional intake after the first weeks and should assess quality of this catch-up growth.
Portions of this study were funded by the Wilhelmina Research Fund (10-427). The authors declare no conflicts of interest.