MRI Differences Associated with Intrauterine Growth Restriction in Preterm Infants
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Published on: January 7, 2018
Christie J Bruno1, Shreyans Bengani, William A Gomes
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
Insights
Intrauterine growth restriction (IUGR) in preterm infants is linked to smaller thalamus and basal ganglion brain volumes. These brain differences may affect neurodevelopmental outcomes in high-risk infants.
Area of Science:
- Neonatal Neurology
- Developmental Neuroscience
- Pediatric Radiology
Background:
- Preterm infants face neurodevelopmental impairment risks.
- Intrauterine growth restriction (IUGR) exacerbates these risks.
- Brain imaging near term-equivalent age aids prognosis.
Purpose of the Study:
- To assess the link between intrauterine growth and regional brain volumes in preterm infants.
- To analyze MRI scans at term-equivalent age for volumetric differences.
- To investigate IUGR's impact on thalamic, basal ganglion, and cerebellar volumes.
Main Methods:
- Retrospective case-control study of 24 preterm infants (gestational age ≤30 weeks).
- Matched IUGR infants with appropriate for gestational age (AGA) controls.
- Analyzed pre-discharge MRI scans (≥36 weeks' adjusted age) for regional brain volumes.
Main Results:
- IUGR infants showed significantly smaller thalamus and basal ganglion volumes compared to AGA infants.
- No significant difference in cerebellar volumes was observed between groups.
- Adjusted linear regression confirmed the association between IUGR and reduced brain volumes.
Conclusions:
- Reduced thalamus and basal ganglion volumes are evident in preterm infants with IUGR.
- These volumetric differences may negatively impact neurodevelopmental outcomes.
- Further research is warranted to understand the long-term implications.
Background:
Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis.
Objective:
To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age.
Methods:
This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants.
Results:
Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI.
Conclusions:
Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships.
