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Brain Volumes at Term-Equivalent Age Are Associated with 2-Year Neurodevelopment in Moderate and Late Preterm
Jeanie L Y Cheong1, Deanne K Thompson2, Alicia J Spittle3
1Neonatal Services, Royal Women's Hospital, Parkville, Australia; Department of Obstetrics and Gynecology, University of Melbourne, Melbourne, Australia; Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.
Insights
Larger brain volumes in preterm infants at term-equivalent age correlate with better cognitive, language, and motor skills at two years. Brain size is a key indicator for neurodevelopmental outcomes in these children.
Area of Science:
- Neonatal neuroscience
- Developmental pediatrics
- Neuroimaging
Background:
- Moderate and late preterm birth are associated with increased risks of neurodevelopmental deficits.
- Early identification of factors influencing neurodevelopment in preterm infants is crucial for timely intervention.
- Brain maturation and structural development are key determinants of long-term cognitive and motor outcomes.
Purpose of the Study:
- To investigate the relationship between brain maturation, injury, and volume at term-equivalent age and 2-year developmental outcomes.
- To identify specific brain metrics that predict neurodevelopmental trajectories in moderate and late preterm children.
- To assess the utility of brain magnetic resonance imaging (MRI) in predicting developmental outcomes.
Main Methods:
- A cohort of moderate and late preterm infants was recruited at birth.
- Brain MRI was performed at term-equivalent age to assess maturation and injury.
- Neurodevelopment was evaluated at 2 years using the Bayley Scales of Infant and Toddler Development, Third Edition.
- Linear regression analyses explored associations between MRI measures and developmental scores.
Main Results:
- Larger total brain tissue, white matter, and cerebellar volumes were significantly associated with higher cognitive, language, and motor scores at 2 years.
- Specifically, larger cerebellar volumes independently predicted better language and motor outcomes.
- Brain maturation markers (myelination, gyral folding) and visible injury showed limited association with 2-year development.
Conclusions:
- Increased brain volumes at term-equivalent age are linked to superior neurodevelopmental outcomes in moderate and late preterm children.
- Brain volume measurements serve as a potential biomarker for predicting neurodevelopmental deficits in this population.
- Further research can refine the use of neuroimaging for personalized developmental assessments in preterm infants.
Objective:
To explore the association between brain maturation, injury, and volumes at term-equivalent age with 2-year development in moderate and late preterm children.
Study Design:
Moderate and late preterm infants were recruited at birth and assessed at age 2 years using the Bayley Scales of Infant and Toddler Development, Third Edition. Brain magnetic resonance imaging (MRI) was performed at term-equivalent age and qualitatively assessed for brain maturation (myelination of the posterior limb of the internal capsule and gyral folding) and injury. Brain volumes were measured using advanced segmentation techniques. The associations between brain MRI measures with developmental outcomes were explored using linear regression analyses.
Results:
A total of 197 children underwent MRI and assessed using the Bayley Scales of Infant and Toddler Development, Third Edition. Larger total brain tissue volumes were associated with higher cognitive and language scores (adjusted coefficients per 10% increase in brain size; 95% CI of 3.2 [0.4, 5.6] and 5.6 [2.4, 8.8], respectively). Similar relationships were documented for white matter volumes with cognitive and language scores, multiple cerebral structures with language scores, and cerebellar volumes with motor scores. Larger cerebellar volumes were independently associated with better language and motor scores, after adjustment for other perinatal factors. There was little evidence of relationships between myelination of the posterior limb of the internal capsule, gyral folding, or injury with 2-year development.
Conclusions:
Larger total brain tissue, white matter, and cerebellar volumes at term-equivalent age are associated with better neurodevelopment in moderate and late preterm children. Brain volumes may be an important marker for neurodevelopmental deficits described in moderate and late preterm children.
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