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Effects of gestational age on brain volume and cognitive functions in generally healthy very preterm born children

Sakari Lemola1, Nadine Oser2, Natalie Urfer-Maurer3

  • 1Department of Psychology, University of Warwick, Coventry, United Kingdom.

Plos One
|August 30, 2017
PubMed

Insights

Gestational age (GA) impacts brain volume and cognitive function in school-aged children. Extremely preterm infants (<28 weeks gestation) show reduced brain matter and lower IQ, suggesting a threshold effect for developmental outcomes.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Cognitive Science

Background:

  • Gestational age (GA) is a critical determinant of neurodevelopment.
  • Previous research suggests a continuous relationship between GA and cognitive outcomes.
  • The potential for a threshold effect in preterm infants requires further investigation.

Purpose of the Study:

  • To investigate whether the association between gestational age (GA) and brain volumes/cognitive functions follows a linear or threshold model in school-aged children.
  • To compare brain structure and cognitive performance between preterm and term-born children.
  • To identify specific GA thresholds associated with significant differences in neurodevelopmental outcomes.

Main Methods:

  • Voxel-based morphometry (VBM) using statistical parametric mapping (SPM) for neuroimaging.
  • Cognitive function assessment using the Wechsler Intelligence Scale for Children-IV (WISC-IV).
  • Statistical analysis using General Linear Models and multiple regressions, controlling for age, sex, and maternal education.

Main Results:

  • Children born <28 weeks gestation exhibited significantly lower gray matter volume (GMV) and white matter volume (WMV) compared to those born at 30+ weeks gestation.
  • Extremely preterm infants (<28 weeks gestation) demonstrated poorer cognitive functions, including lower full-scale IQ and processing speed.
  • Reduced GMV partially mediated the association between GA and full-scale IQ in preterm children.

Conclusions:

  • Gestational age is significantly associated with brain volume and cognitive functions in appropriate-for-gestational-age (AGA) preterm children without major complications.
  • A notable decrease in brain volume becomes apparent in extremely preterm infants (born <28 weeks gestation).
  • The relationship between GA, brain volume, and cognitive function may be less pronounced in preterm infants born at 30 completed weeks gestation and later than previously assumed.
Abstract

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