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Association of Gestational Age at Birth With Brain Morphometry
Hanan El Marroun1,2,3, Runyu Zou1, Michelle F Leeuwenburg1
1Department of Child and Adolescent Psychiatry, University Medical Center Rotterdam, Erasmus Medical Center, Rotterdam, the Netherlands.
Insights
Longer gestational age at birth is linked to larger brain volumes in children, even for full-term births. This finding highlights the importance of gestational duration for child neurodevelopment.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatrics
Background:
- Preterm and postterm births are linked to adverse neuropsychiatric outcomes.
- The impact of gestational age within the term range on neurodevelopment is not well understood.
Purpose of the Study:
- To investigate the association between gestational age at birth (GAB) and structural brain morphometry in 10-year-old children.
Main Methods:
- A population-based cohort study of 3079 children from the Generation R Study in Rotterdam.
- Gestational age at birth was determined via early pregnancy ultrasonography.
- Structural brain morphometry was assessed using magnetic resonance imaging at 10 years of age.
Main Results:
- Gestational age at birth showed a linear association with global and regional brain volumes.
- Each additional week of gestation corresponded to a 4.5 cm³/week increase in total brain volume.
- These associations remained significant even when restricting the analysis to term-born infants (37-42 weeks).
Conclusions:
- Gestational duration is linearly associated with brain morphometry in childhood, including within the term birth window.
- These findings have significant clinical implications, especially considering the rise in elective deliveries.
- Optimizing gestational duration may be crucial for optimal neurodevelopment.
Importance:
Preterm and postterm births are associated with adverse neuropsychiatric outcomes. However, it remains unclear whether variation of gestational age within the 37- to 42-week range of term deliveries is associated with neurodevelopment.
Objective:
To investigate the association of gestational age at birth (GAB) with structural brain morphometry in children aged 10 years.
Design, Setting, And Participants:
This population-based cohort study included pregnant women living in Rotterdam, the Netherlands, with an expected delivery date between April 1, 2002, and January 31, 2006. The study evaluated 3079 singleton children with GAB ranging from 26.3 to 43.3 weeks and structural neuroimaging at 10 years of age from the Generation R Study, a longitudinal, population-based prospective birth cohort from early pregnancy onward in Rotterdam. Data analysis was performed from March 1, 2019, to February 28, 2020, and at the time of the revision based on reviewer suggestions.
Exposures:
The GAB was calculated based on ultrasonographic assessment of crown-rump length (<12 weeks 5 days) or biparietal diameter (≥12 weeks 5 days) in dedicated research centers.
Main Outcomes And Measures:
Brain structure, including global and regional brain volumes and surface-based cortical measures (thickness, surface area, and gyrification), was quantified by magnetic resonance imaging.
Results:
In the 3079 children (1546 [50.2%] female) evaluated at 10 years of age, GAB was linearly associated with global and regional brain volumes. Longer gestational duration was associated with larger brain volumes; for example, every 1-week-longer gestational duration corresponded to an additional 4.5 cm3/wk (95% CI, 2.7-6.3 cm3/wk) larger total brain volume. These associations persisted when the sample was restricted to children born at term (GAB of 37-42 weeks: 4.8 cm3/wk; 95% CI, 1.8-7.7 cm3/wk). No evidence of nonlinear associations between GA and brain morphometry was observed.
Conclusions And Relevance:
In this cohort study, gestational duration was linearly associated with brain morphometry during childhood, including within the window of term delivery. These findings may have marked clinical importance, particularly given the prevalence of elective cesarean deliveries.
