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Brain Volumes and Developmental Outcome in Childhood Following Fetal Growth Restriction Leading to Very Preterm Birth

Eva Morsing1, Mariya Malova2, Anna Kahn3

  • 1Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.

Frontiers in Physiology
|December 4, 2018
PubMed

Insights

Children born very preterm with fetal growth restriction (FGR) show cognitive deficits, but brain volumes are mainly linked to prematurity, not FGR itself. Regional brain volumes did not predict cognitive or motor function beyond gestational age.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Radiology

Background:

  • Children born very preterm (PT) often experience cognitive impairments, particularly those with fetal growth restriction (FGR).
  • The specific impact of FGR on neurodevelopment and regional brain volumes in PT children remains unclear.
  • Understanding these relationships is crucial for early intervention and improving long-term outcomes.

Purpose of the Study:

  • To investigate the association between regional brain volumes and neurodevelopmental outcomes in children born very preterm with FGR.
  • To compare brain volumes and cognitive/motor functions between PT-FGR, PT-AGA, and term-AGA children.
  • To determine if FGR or prematurity is the primary driver of observed neurodevelopmental differences.

Main Methods:

  • Magnetic resonance imaging (MRI) was used to measure brain volumes in 23 PT-FGR, 24 PT-AGA, and 27 term-AGA children at early school age.
  • Cognitive function was assessed using the Wechsler Intelligence Scales for Children.
  • Motor function was evaluated using the ABC-Movement score.

Main Results:

  • PT-FGR children had significantly lower full-scale IQ scores compared to PT-AGA children (80 vs 103).
  • PT-FGR children exhibited reduced total, gray matter, white matter, thalamic, cerebellar white matter, and hippocampal volumes versus term-AGA controls.
  • No significant differences in brain volumes were found between PT-FGR and PT-AGA groups; hippocampal volume reduction correlated with birth weight (r=0.46, p=0.05).

Conclusions:

  • Brain volumes in early school-aged children are primarily influenced by the degree of prematurity rather than fetal growth restriction.
  • Regional brain volumes did not independently predict cognitive or motor function beyond the effects of gestational age at birth.
  • These findings suggest that interventions targeting prematurity-related factors may be more impactful than those solely focused on FGR for neurodevelopmental outcomes.

Keywords:
brain volumesfetal growth restrictionmagnetic resonance imagingneuro-developmentpreterm birth

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