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Published on: August 25, 2014
Associations between Neonatal Magnetic Resonance Imaging and Short- and Long-Term Neurodevelopmental Outcomes in a
Lisette Jansen1, Andrea van Steenis2, Annette A van den Berg-Huysmans3
1Department of Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands; Curium-LUMC Department of Child and Adolescent Psychiatry, Leiden, the Netherlands.
Insights
Neonatal brain injury in very preterm infants impacts early cognitive, motor, and behavioral development. While these effects diminish by age 10, environmental factors like maternal education become crucial for cognitive outcomes.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Neonatal brain injury is a significant concern in very preterm infants.
- Early brain injury can have long-term neurodevelopmental consequences.
- Understanding the trajectory of these outcomes is crucial for intervention.
Purpose of the Study:
- To investigate the association between neonatal brain injury, assessed via MRI, and neurodevelopmental outcomes at 2 and 10 years of age.
- To evaluate the influence of injury severity and environmental factors on long-term outcomes.
Main Methods:
- A longitudinal study of 112 children born before 32 weeks gestation.
- Neonatal brain injury and growth were assessed using the Kidokoro score on MRI.
- Cognitive, motor, and behavioral outcomes were evaluated at 2 and 10 years corrected age.
Main Results:
- Global brain abnormality scores correlated with cognition, motor skills, and behavior at 2 years.
- These associations were not significant for cognition at 10 years.
- Moderate-to-severe injury predicted cognitive impairment at 10 years, while milder injuries were more influenced by birth weight and maternal education.
Conclusions:
- Neonatal brain injury is linked to short-term neurodevelopmental deficits.
- Motor and behavioral outcomes in childhood are associated with early brain injury.
- Maternal education plays an increasingly important role in cognitive development, particularly for those with milder neonatal brain injuries.
Objective:
To assess associations between neonatal brain injury assessed by magnetic resonance imaging and cognitive, motor, and behavioral outcomes at 2 and 10 years of age, in a longitudinal cohort of children born very preterm.
Study Design:
There were 112 children born at <32 weeks of gestation who participated in a longitudinal prospective study on brain injury and neurodevelopmental outcome. Using the Kidokoro score, neonatal brain injury and altered brain growth in white matter, cortical and deep gray matter, and the cerebellum were assessed. Cognitive, motor, and behavioral outcomes were assessed during follow-up visits at both 2 (corrected) and 10 years of age.
Results:
After adjusting for perinatal factors and level of maternal education, the global brain abnormality score was associated with cognition (B = -1.306; P = .005), motor skills (B = -3.176; P < .001), and behavior (B = 0.666; P = .005) at 2 years of age, but was not associated with cognition at 10 years of age. In the subgroup of children with a moderate-severe global brain abnormality score, magnetic resonance imaging was independently associated with cognitive impairment at 10 years of age. For children with milder forms of brain injury, only birth weight and level of maternal education were associated with cognitive outcomes.
Conclusions:
Neonatal brain injury, assessed by a standardized scoring system, was associated with short-term neurodevelopmental outcomes, but only with motor skills and behavior in childhood. Environmental factors, such as level of maternal education, become more important for cognitive development as children grow older, especially for children with relatively mild neonatal brain injury.
