Invasive procedures in preterm children: brain and cognitive development at school age

Area of Science:

• Neonatology
• Neuroscience
• Developmental Pediatrics

Background:

• Very preterm infants experience numerous invasive procedures during neonatal care.
• Studies in rodents and human neonates suggest a link between invasive procedures and altered brain development.
• The long-term effects of invasive procedures on brain microstructure and cognitive outcomes in very preterm children are not well understood.

Purpose of the Study:

• To investigate the association between the number of invasive procedures in very preterm infants and long-term brain microstructure and cognitive function at school age.
• To determine if invasive procedures impact white matter maturation and intelligence quotient (IQ).

Main Methods:

• Fifty children born very preterm underwent MRI and cognitive testing at a median age of 7.6 years.
• Diffusion tensor imaging measured fractional anisotropy (FA) in seven white matter regions.
• Cognitive function was assessed using the Wechsler Intelligence Scale for Children-IV.
• Multivariate modeling adjusted for clinical confounders.

Main Results:

• A higher number of invasive procedures was significantly associated with lower white matter fractional anisotropy (FA) at age 7 years.
• An interaction between the number of procedures and FA predicted IQ, with more procedures and lower superior white matter FA linked to lower IQ.

Conclusions:

• Invasive procedures during neonatal care are associated with long-term white matter microstructure abnormalities in children born very preterm.
• These procedures may contribute to reduced cognitive outcomes, specifically lower IQ, in later childhood.