Related Experiment Video
Updated: Jul 13, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Early growth in brain volume is preserved in the majority of preterm infants
James P Boardman1, Serena J Counsell, Daniel Rueckert
1Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom. j.boardman@imperial.ac.uk
Insights
Reduced brain growth in preterm infants is not inevitable. Prolonged supplemental oxygen is a risk factor for early brain growth attenuation, not prematurity itself.
Area of Science:
- Neonatal neuroscience
- Pediatric neuroimaging
- Developmental biology
Background:
- Preterm infants often exhibit reduced cerebral tissue volumes in adolescence.
- The inevitability of reduced global brain growth post-prematurity is unclear.
Purpose of the Study:
- To determine if reduced global brain growth in preterm infants is inevitable or linked to specific neonatal medical risk factors.
- Investigate the association between neonatal risk factors and early brain development in preterm infants.
Main Methods:
- Deformation-based morphometry was used to analyze brain volumes in 89 preterm infants and 20 full-term controls.
- Whole-brain and ventricular volumes were calculated and correlated with clinical data, excluding focal brain lesions.
Main Results:
- Overall cerebral volume was not significantly different between preterm and control infants.
- Supplemental oxygen requirement at 28 days was associated with lower cerebral volume (p < 0.001).
- Perinatal sepsis and diffuse white matter injury did not significantly impact cerebral volumes.
Conclusions:
- Global brain growth is not universally reduced in preterm infants during intensive care.
- Prolonged supplemental oxygen dependence is a significant risk factor for early global brain growth attenuation.
- Reduced brain volume in adolescents born preterm may stem from specific neonatal conditions or later factors, not prematurity alone.
Objective:
Preterm infants have reduced cerebral tissue volumes in adolescence. This study addresses the question: Is reduced global brain growth in the neonatal period inevitable after premature birth, or is it associated with specific medical risk factors?
Methods:
Eighty-nine preterm infants at term equivalent age without focal parenchymal brain lesions were studied with 20 full-term control infants. Using a deformation-based morphometric approach, we transformed images to a reference anatomic space, and we used the transformations to calculate whole-brain volume and ventricular volume for each subject. Patterns of volume difference were correlated with clinical data.
Results:
Cerebral volume is not reduced compared with term born control infants (p = 0.765). Supplemental oxygen requirement at 28 postnatal days is associated with lower cerebral tissue volume at term (p < 0.001), but there were no significant differences in cerebral volumes attributable to perinatal sepsis (p = 0.515) and quantitatively defined diffuse white matter injury (p = 0.183). As expected, the ventricular system is significantly larger in preterm infants at term equivalent age compared with term control infants (p < 0.001).
Interpretation:
Cerebral volume is not reduced during intensive care for the majority of preterm infants, but prolonged supplemental oxygen dependence is a risk factor for early attenuation of global brain growth. The reduced cerebral tissue volume seen in adolescents born preterm does not appear to be an inevitable association of prematurity, but rather caused by either specific disease during intensive care or factors operating beyond the neonatal period.
