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A Rat Model of Mild Intrauterine Hypoperfusion with Microcoil Stenosis
Published on: January 7, 2018
Differential effects of intrauterine growth restriction on brain structure and development in preterm infants: a
Nelly Padilla1, Carles Falcón, Magdalena Sanz-Cortés
1Department of Maternal-Fetal Medicine, Hospital Clínic, Universidad de Barcelona, Calle Sabino de Arana 1, 08028, Barcelona, Spain. fpadilla@clinic.ub.es
Insights
Infants born with intrauterine growth restriction (IUGR) show persistent brain structure differences and developmental delays at one year. These neurostructural changes in preterm IUGR infants impact cognitive development.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Intrauterine growth restriction (IUGR) is linked to neurodevelopmental issues in preterm infants.
- Long-term neurostructural effects of IUGR in early childhood remain unclear.
Purpose of the Study:
- To investigate persistent neurostructural brain anomalies in preterm infants with IUGR at 12 months corrected age (CA).
- To correlate brain structure with neurodevelopmental outcomes at 18 months CA.
Main Methods:
- Compared brain MRI scans (12 months CA) of preterm IUGR (n=18), preterm appropriate-for-gestational-age (AGA, n=15), and term infants (n=15).
- Utilized automated lobar volumetry and voxel-based morphometry (VBM) for structural analysis.
- Assessed neurodevelopment using the Bayley Scale for Infant and Toddler Development (18 months CA).
Main Results:
- IUGR infants exhibited reduced insular and temporal lobe volumes.
- VBM revealed widespread gray matter reduction in IUGR infants across multiple brain regions.
- Altered white matter volumes (increased in temporal, frontal, parietal, occipital, insular; decreased in cerebellum) were observed in IUGR infants.
- IUGR infants scored lower on neurodevelopmental assessments, correlating with gray matter volumes.
Conclusions:
- Preterm IUGR infants demonstrate persistent, distinct patterns of brain structural changes at one year of age.
- These neurostructural alterations are associated with specific developmental difficulties in early childhood.
Abstract:
Previous evidence suggests that preterm newborns with intrauterine growth restriction (IUGR) have specific neurostructural and neurodevelopmental anomalies, but it is unknown whether these effects persist in early childhood. We studied a sample of 18 preterm IUGR, 15 preterm AGA - born between 26 and 34 weeks of gestational age (GA) - and 15 healthy born-term infants. Infants were scanned at 12 months corrected age (CA), in a 3T scanner, without sedation. Analyses were made by automated lobar volumetry and voxel-based morphometry (VBM). The neurodevelopmental outcome was assessed in all subjects at 18 months CA with the Bayley Scale for Infant and Toddler Development, third edition. IUGR infants had reduced relative volumes for the insular and temporal lobes. According to VBM, IUGR infants had bilateral reduced gray matter (GM) in the temporal, parietal, frontal, and insular regions compared with the other groups. IUGR infants had increased white matter (WM) in temporal regions compared to the AGA group and in frontal, parietal, occipital, and insular regions compared to the term group. They also showed decreased WM in the cerebellum and a non-significant trend in the hippocampus compared to term infants. IUGR infants had reduced neurodevelopmental scores, which were positively correlated with GM in various regions. These data suggest that the IUGR induces a distinct brain pattern of structural changes that persist at 1 year of life and are associated with specific developmental difficulties.
