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Does very preterm birth impair myelination of the central nervous system?
M van de Bor1, G L Guit, A M Schreuder
1Department of Pediatrics, University Hospital Leiden, The Netherlands.
Insights
Adequate nutrition supports central nervous system (CNS) myelination in very preterm infants. Magnetic resonance (MR) imaging showed similar myelination stages in preterm and term infants, indicating optimal development with proper nutritional support.
Area of Science:
- Neuroscience
- Neonatology
- Radiology
Background:
- Neonatal undernutrition can impair central nervous system (CNS) myelination.
- Very preterm infants exhibit slower postnatal growth compared to intrauterine fetuses.
- Magnetic resonance (MR) imaging is a key tool for assessing CNS myelination.
Purpose of the Study:
- To evaluate qualitative myelination patterns in very preterm infants receiving optimal nutrition.
- To compare myelination stages between preterm infants and term-born infants at 44 weeks postmenstrual age (PMA).
Main Methods:
- Utilized MR imaging to assess myelination patterns.
- Included healthy preterm infants (<30 weeks gestation) with optimal nutrition.
- Included term infants at 44 weeks PMA for comparison.
Main Results:
- Both preterm and term infants achieved myelination stages M3 and M4.
- No significant differences in myelination stages were observed between the groups.
- Preterm infants had lower mean body weight but similar head circumference compared to term infants.
Conclusions:
- Optimal neonatal nutrition supports qualitatively adequate CNS myelination in very preterm infants.
- MR imaging demonstrates comparable myelination development in well-nourished preterm and term infants.
Abstract:
Myelination of the central nervous system (CNS) can be demonstrated with magnetic resonance (MR) imaging. Myelin formation may be reduced in conditions of neonatal "undernutrition". Very preterm infants have a reduced postnatal growth rate when compared with intrauterine fetuses of the same gestational age. Using MR imaging, we studied qualitative myelination patterns in healthy preterm infants of less than 30 weeks gestation with an optimal nutritional intake and in term infants at 44 weeks postmenstrual age (PMA). At that age, preterm infants had a significantly lower mean body weight than term infants, but mean head circumference did not differ significantly. All preterm and term infants had reached myelination stage M3 (myelin in brainstem, internal capsule, and corona radiata) and M4 (myelin in brainstem, internal capsule, corona radiata, and centrum semiovale). There was no significant difference in myelination stage between the preterm and term infants. We conclude that adequate nutrition in the neonatal period leads to qualitatively adequate myelination of the CNS in very preterm infants.