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Sex differences in cerebral volumes of 8-year-olds born preterm
Allan L Reiss1, Shelli R Kesler, Betty Vohr
1Stanford Psychiatry Neuroimaging Laboratory and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 94305, USA. reiss@stanford.edu
Insights
Preterm birth significantly reduces brain gray and white matter volumes. Male preterm infants show greater white matter reductions, while females exhibit stronger links between brain structure, neonatal risks, and cognitive outcomes.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatrics
Background:
- Preterm birth impacts neurodevelopment, potentially leading to long-term cognitive and structural deficits.
- Sex-based differences in brain development may influence vulnerability to preterm birth complications.
Purpose of the Study:
- To investigate sex-specific effects of preterm birth on cerebral gray matter (GM) and white matter (WM) volumes at 8 years of age.
- To explore associations between neonatal risk factors, brain structure, and cognitive outcomes in preterm children, considering sex differences.
Main Methods:
- Magnetic Resonance Imaging (MRI) was used to assess GM and WM volumes in 65 preterm children and 31 term-born controls at 8 years old.
- Statistical analyses examined group differences and correlations between birth weight, intraventricular hemorrhage (IVH), brain volumes, and cognitive outcomes, stratified by sex.
Main Results:
- Preterm children had significantly reduced GM and WM volumes compared to controls.
- Males born preterm showed significantly reduced WM volumes compared to term-born males; WM volumes were similar between preterm and term females.
- Lower birth weight correlated with reduced WM in both sexes; IVH was associated with reduced GM in preterm girls only.
- Positive correlations between GM and cognitive outcome were found in preterm girls but not boys.
Conclusions:
- Preterm birth adversely affects cerebral GM and WM development, with males being particularly vulnerable regarding WM.
- Neonatal factors like birth weight and IVH have sex-specific associations with brain structure.
- Girls born preterm demonstrate a stronger relationship between neuro-anatomical measures, neonatal risk factors, and cognitive performance, highlighting sex-influenced developmental trajectories.
Abstract:
We investigate sex-associated effects of preterm birth on cerebral gray matter (GM) and white matter (WM) volumes. Preterm children (n=65) and 31 healthy, term control children had usable magnetic resonance imaging (MRI) data acquired at 8 years of age. Both GM and WM volumes were significantly reduced in the preterm group compared with controls. However, only males with preterm birth had significantly reduced WM compared with term males (P=.021), whereas WM volumes were equivalent in the female groups. Lower birth weight was associated with reduced WM in both boys and girls with preterm birth, whereas intraventricular hemorrhage (IVH) was associated with reduced GM in girls only. Positive correlations between GM and cognitive outcome were observed in girls with preterm birth but not boys. We conclude that preterm birth has a significant impact on brain development with increased risk for smaller GM and WM cerebral volumes. Males appear particularly vulnerable to adverse effects of preterm birth on WM development. However, girls with preterm birth show stronger correlations between neuro-anatomical variables and both neonatal risk factors and cognitive outcome, compared with boys. These findings indicate that the sex of the very preterm newborn influences the mechanisms by which the developing brain is affected.
