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Cerebral MRI findings in a cohort of ex-preterm and control adolescents
1Department of Woman and Child Health, Neonatalogy, Karolinska Institute, Stockholm, Sweden. zoltan.nagy@ki.se
Insights
Adolescents born preterm had fewer brain abnormalities on MRI than expected, likely due to minimally invasive neonatal care and Swedish social structures. This study tracked preterm infants long-term.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Preterm birth is a significant risk factor for neurodevelopmental challenges.
- Cerebral magnetic resonance imaging (MRI) is crucial for assessing brain structure in preterm infants.
- International comparisons of neuroimaging outcomes in preterm populations are essential for understanding variations in care and outcomes.
Purpose of the Study:
- To compare cerebral magnetic resonance imaging (MRI) findings in adolescents born preterm with international cohort data.
- To investigate the long-term structural brain outcomes of individuals born preterm.
- To identify potential factors influencing neuroimaging results in ex-preterm individuals.
Main Methods:
- Prospective, long-term follow-up study of preterm-born infants.
- Cerebral MRI examinations (1.5T scanner, T1- and T2-weighted images) performed on ex-preterm and control participants.
- Independent and consensus review of MRI scans by experienced neuroradiologists.
Main Results:
- A low overall rate of brain abnormalities (21/143 scans), mostly mild.
- Ex-preterm adolescents showed mild white matter loss or gliosis, with some having incidental findings.
- No significant relationship found between the extent/severity of injury and being born small for gestational age.
Conclusions:
- The rate of structural brain abnormalities in Swedish adolescents born preterm was lower than reported internationally.
- Minimally invasive neonatal care practices in Sweden may contribute to better neuroimaging outcomes.
- Distinct social structures in Sweden could also play a role in the observed lower rates of abnormalities.
Aim:
Newborn infants were entered between 1988 and 1993 into a prospective, long-term, follow-up study. We aimed to investigate how the outcome of preterm-born individuals on cerebral magnetic resonance imaging (MRI) compared to that reported on similar cohorts internationally.
Methods:
The 74 ex-preterm (12.38-17.7 years, 51% girls) and 69 control participants (12.18-16.47 years, 53% girls) underwent a MRI examination on a 1.5T scanner. Two experienced neuroradiologists examined the T1- and T2-weighted images first independently and then in consensus without knowledge of group adherence.
Results:
Only 21 (4 controls) of the 143 sets of scans showed any abnormalities. All but one of these were of mild extent. Among the ex-preterm adolescents two showed only incidental findings while the other 15 had either gliosis or white matter loss. Eleven subjects had white matter loss, seven of which had no other abnormalities. Four subjects had gliosis, three of which had no other abnormalities. The extent, severity or frequency of injury was not related to being born small for gestational age.
Conclusion:
Although the rate of structural abnormalities was higher in the group of adolescents born preterm, this rate was well below that reported from other centres around the world. We attribute this to the minimally invasive neonatal care and to different social structures in Sweden compared to that of other reports on similar cohorts.
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