Very preterm (VPT) infants with small biparietal width (BPW) and increased interhemispheric distance (IHD), measurements of brain growth at term (37-42 weeks gestation) by magnetic resonance imaging (MRI), were both independently associated with impaired cognitive development at age 2.
Evidence Rating Level: 2 (Good)
Study Rundown: MRI aids in the identification of brain injuries in preterm infants. However, imaging results may not always correlate with future neurodevelopmental impairments, such as cognitive and behavioral challenges. The purpose of this study was to further understand (using MRI measurements) how brain injury and brain growth in VPT infants are related to developmental outcomes at 2 years of age. Researchers found that infants with higher grade brain injuries had delayed neurodevelopmental function at 2 years. Similarly, the lowest cognitive function at age 2 was seen in preterm infants with both small BPW and increased IHD on MRI scan at term. Results may be limited as the gold standard for brain volume measurement was not used, cohorts were located in different regional environments and received different treatments. These findings may aid physicians in their predictions for future neurodevelopment of preterm infants with these specific brain growth measurements.
Relevant Reading: Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s
In-Depth [prospective cohort study]: Data obtained from the charts of 325 infants from 3 different cohorts (Christchurch Women’s Hospital in Christchurch, New Zealand; Royal Women’ Hospital in Melbourne, Australia; St. Louis Children’s Hospital in St. Louis, Missouri) born at <30 weeks gestation and with an MRI obtained at ≥37 and ≤42 weeks gestation were examined. Neurodevelopment was assessed in children at age 2 using the Bayley Scales of Infant Development. Brain injuries (Pariventricular leukomalacia-PVL, cerebellar hemorrhage-CBH, and intraventricular hemorrhage-IVH) were seen in 33% of all participants and high grade injuries were identified in 10%. In the Christchurch and Melbourne cohorts, children with high grade PVL (P <.001) or IVH (P <.05) had the lowest neurodevelopmental scores at age 2 compared to those without any brain injury. A similar trend was observed in the St. Louis cohort. Multivariable analysis demonstrated that small BPW (P = 001) and increased IHD (P < .001) were independently associated with decreased cognitive ability at 2 years of age.
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