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Published on: November 20, 2015
Severity of perinatal illness and cerebral cortical growth in preterm infants
Tuula Kaukola1, Olga Kapellou, Sabine Laroche
1Department of Paediatrics, Imperial College London, Hammersmith Hospital, London, UK.
Insights
Illness severity after very premature birth predicts reduced cortical surface area growth. Factors like the Clinical Risk Index for Babies (CRIB I) and chronic lung disease significantly impact brain development.
Area of Science:
- Neuroscience
- Developmental Biology
- Neonatology
Background:
- Previous research established that the degree of prematurity influences cortical surface area growth.
- This study investigates the impact of perinatal and postnatal illness severity on this growth trajectory.
Purpose of the Study:
- To determine if peri- and postnatal illness severity predicts cortical surface area growth in infants born very prematurely.
- To quantify the relationship between illness severity scores and brain development outcomes.
Main Methods:
- Cortical surface area was measured in 111 infants (23-29 weeks gestational age) using 269 images.
- Illness severity was assessed via Clinical Risk Index for Babies (CRIB I) and chronic lung disease (CLD) presence.
- Generalized least-square regression modeled the effects of illness on cortical growth, with secondary analysis of CRIB II, C-reactive protein (CRP), and feeding milestones.
Main Results:
- Cortical surface area exhibited a growth rate of 12.4% per week.
- Higher CRIB I scores and the presence of CLD were associated with reduced cortical growth.
- Further analysis revealed that CRIB II scores and elevated CRP levels also predicted diminished growth, while feeding time did not.
Conclusions:
- Illness severity following very premature birth is a significant predictor of reduced cortical growth.
- These findings highlight the critical role of managing infant health in optimizing neurodevelopmental outcomes.
Aim:
We have shown previously that the degree of prematurity affects cortical surface area growth. We now addressed the question whether cortical surface area growth after preterm birth is predicted by the severity of peri- and postnatal illness.
Methods:
Cortical surface area was measured in 269 images from 111 infants born between 23 and 29 weeks and imaged at 23 to 48 weeks gestational age (GA). The severity of perinatal illness was assessed using the clinical risk index for babies score (CRIB I) and the severity of ongoing illness by the presence of chronic lung disease (CLD). The effects on cortical growth were modelled using generalized least-square regression for random effects with Bonferroni correction. To explore the results further we examined CRIB II, C-reactive protein (CRP) on the second day after birth, and time taken to achieve full enteral feeding.
Results:
Cortical surface area grew by 12.4% per week. Reduced cortical growth was predicted by adverse CRIB I (-0.15% per week per unit) and development of CLD (-1.18% per week). Secondary analysis showed that growth was related to adverse CRIB II (-0.36% per week per unit) and increasing CRP (-0.03% per week per mMol), but not by the time taken to achieve full enteral feeding.
Conclusion:
After very premature birth illness severity predicts reduced cortical growth.
