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Published on: May 19, 2015
Moderate and late preterm infants exhibit widespread brain white matter microstructure alterations at term-equivalent
Claire E Kelly1,2, Jeanie L Y Cheong3,4,5, Lillian Gabra Fam3,6
1Murdoch Childrens Research Institute, Melbourne, Australia. claire.armstrongkell@mcri.edu.au.
Insights
Moderate and late preterm infants show widespread white matter differences compared to full-term infants. These brain alterations may explain neurodevelopmental delays in preterm children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Medical Imaging
Background:
- Moderate and late preterm birth (32-36 weeks' gestation) is linked to neurodevelopmental delays.
- Research on white matter microstructure in these infants is limited compared to very preterm infants.
Purpose of the Study:
- To compare whole brain white matter microstructure between moderate/late preterm infants and term-born controls at term-equivalent age.
- To identify perinatal risk factors for white matter alterations in moderate/late preterm infants.
Main Methods:
- Diffusion tensor imaging (DTI) and Tract-Based Spatial Statistics (TBSS) analysis.
- Study included 193 moderate and late preterm infants and 83 term-born controls.
- Assessment performed at term-equivalent age.
Main Results:
- Moderate and late preterm infants exhibited significantly lower fractional anisotropy (FA) and higher mean, axial, and radial diffusivities.
- These microstructural alterations were observed in nearly 70% of major white matter tracts.
- Being small for gestational age and male sex were associated with lower FA in specific tracts (optic radiation, corpus callosum, corona radiata).
Conclusions:
- Moderate and late preterm infants display widespread white matter microstructural alterations at term-equivalent age.
- Findings suggest delayed or disrupted white matter development in this population.
- These alterations may contribute to the observed neurodevelopmental delays in moderate and late preterm children.
Abstract:
Despite the many studies documenting cerebral white matter microstructural alterations associated with very preterm birth (<32 weeks' gestation), there is a dearth of similar research in moderate and late preterm infants (born 32-36 weeks' gestation), who experience higher rates of neurodevelopmental delays than infants born at term (≥ 37 weeks' gestation). We therefore aimed to determine whether whole brain white matter microstructure differs between moderate and late preterm infants and term-born controls at term-equivalent age, as well as to identify potential perinatal risk factors for white matter microstructural alterations in moderate and late preterm infants. Whole brain white matter microstructure was studied in 193 moderate and late preterm infants and 83 controls at term-equivalent age by performing Tract-Based Spatial Statistics analysis of diffusion tensor imaging data. Moderate and late preterm infants had lower fractional anisotropy and higher mean, axial and radial diffusivities compared with controls in nearly 70% of the brain's major white matter fiber tracts. In the moderate and late preterm group, being born small for gestational age and male sex were associated with lower fractional anisotropy, largely within the optic radiation, corpus callosum and corona radiata. In conclusion, moderate and late preterm infants exhibit widespread brain white matter microstructural alterations compared with controls at term-equivalent age, in patterns consistent with delayed or disrupted white matter microstructural development. These findings may underpin some of the neurodevelopmental delays observed in moderate and late preterm children.
