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Behavioural dysfunctions of 10-year-old children born extremely preterm associated with corticotropin-releasing
Alan Leviton1, Elizabeth N Allred1, Robert M Joseph2
1Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Insights
Placental corticotropin-releasing hormone (CRH) levels did not predict later school dysfunctions in extremely preterm children. However, high placental CRH was linked to social limitations in girls.
Area of Science:
- Reproductive biology
- Developmental neuroscience
- Pediatric health
Background:
- Extremely preterm (EP) birth poses risks for neurodevelopmental outcomes.
- Corticotropin-releasing hormone (CRH) plays a role in stress response and development.
- Placental CRH may influence fetal development and long-term health.
Purpose of the Study:
- To investigate the association between placental corticotropin-releasing hormone (CRH) expression and school-related dysfunctions in children born extremely preterm (EP).
- To determine if CRH mRNA levels in the placenta predict neurodevelopmental and behavioral outcomes at age 10.
Main Methods:
- Placental CRH mRNA expression was quantified in 761 EP children.
- Children underwent comprehensive neurodevelopmental and behavioral assessments at age 10.
- Statistical analyses examined associations between extreme CRH mRNA quartiles and adverse assessment scores.
Main Results:
- Overall, no significant association was found between the highest or lowest placental CRH mRNA quartiles and increased risks of school-related dysfunctions.
- A notable finding was that seven indicators of social limitations were associated with the highest quartile of placental CRH mRNA in girls.
- Adjustments for delivery indications minimally altered these findings.
Conclusions:
- Placental CRH mRNA levels, in isolation, do not appear to be a strong predictor of general school-related dysfunctions in EP children at age 10.
- Specific to girls, elevated placental CRH expression may be linked to an increased risk of social challenges.
- Further research is needed to understand the nuanced role of CRH in sex-specific developmental trajectories following EP birth.
Aim:
To evaluate the relationship between corticotropin-releasing hormone (CRH) expression in the placenta and the risk of school-related dysfunctions at the age of 10 years among children born extremely preterm (EP).
Methods:
Corticotropin-releasing hormone expression was measured in the placenta of 761 EP children, who had the following assessments at the age of 10 years: Differential Ability Scales, Oral and Written Language Scales, the Wechsler Individual Achievement Test-III, NEPSY-II and the Child Symptom Inventory-4. We evaluated whether lowest and highest quartiles of CRH mRNA were associated with undesirable scores on these assessments. With 272 evaluations, we would expect 14 to be significant at p < 0.05.
Results:
Only 16 associations were statistically significant. On the other hand, seven of these were social limitations among girls whose placenta CRH mRNA was in the top quartile. Adjusting for delivery indication or restricting the sample to one delivery indication group resulted in few differences.
Conclusion:
Overall, placenta CRH mRNA concentrations in the top or bottom quartiles were not associated with increased risks of dysfunctions 10 years later. Girls whose placenta CRH expression was in the top quartile, however, were at increased risk of seven indicators/correlates of social limitations.
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