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Effects of gestational age at birth on perinatal structural brain development in healthy term-born babies
Oliver Gale-Grant1,2,3, Sunniva Fenn-Moltu1,2, Lucas G S França1,2
1Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Insights
Early term birth (37-38 weeks) is linked to subtle brain differences and lower neurodevelopmental scores at 18 months. Neuroimaging in newborns reveals brain structure and white matter variations associated with gestational age at birth.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Infants born at early term (37-38 weeks gestation) exhibit slower neurodevelopment compared to full-term infants (40-41 weeks).
- Gestational age at birth may directly influence brain development, independent of perinatal morbidity.
Purpose of the Study:
- To characterize brain volume and white matter differences in relation to gestational age at birth in healthy term-born neonates.
- To investigate the association between neonatal neuroimaging findings and later neurodevelopmental outcomes.
Main Methods:
- Utilized T2 and diffusion-weighted MRI on 454 healthy term-born infants scanned within 41 days of birth.
- Employed tensor-based morphometry and tract-based spatial statistics for image analysis.
- Assessed neurodevelopment at 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).
Main Results:
- Earlier gestational age at birth correlated with increased relative ventricular volume and decreased relative brain volume in deep grey matter, cerebellum, and brainstem.
- Lower fractional anisotropy and higher diffusivity (mean, axial, radial) were observed in major white matter tracts for earlier-born infants.
- Gestational age at birth positively predicted all Bayley-III subscales at 18 months, with neuroimaging features improving predictive models.
Conclusions:
- Early term birth is associated with measurable differences in neonatal brain structure and white matter integrity.
- Gestational age at birth is a significant factor in neurodevelopmental outcomes, even in healthy term-born infants.
- Neonatal neuroimaging findings provide valuable insights into the impact of gestational age on brain development and later function.
Abstract:
Infants born in early term (37-38 weeks gestation) experience slower neurodevelopment than those born at full term (40-41 weeks gestation). While this could be due to higher perinatal morbidity, gestational age at birth may also have a direct effect on the brain. Here we characterise brain volume and white matter correlates of gestational age at birth in healthy term-born neonates and their relationship to later neurodevelopmental outcome using T2 and diffusion weighted MRI acquired in the neonatal period from a cohort (n = 454) of healthy babies born at term age (>37 weeks gestation) and scanned between 1 and 41 days after birth. Images were analysed using tensor-based morphometry and tract-based spatial statistics. Neurodevelopment was assessed at age 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants born earlier had higher relative ventricular volume and lower relative brain volume in the deep grey matter, cerebellum and brainstem. Earlier birth was also associated with lower fractional anisotropy, higher mean, axial, and radial diffusivity in major white matter tracts. Gestational age at birth was positively associated with all Bayley-III subscales at age 18 months. Regression models predicting outcome from gestational age at birth were significantly improved after adding neuroimaging features associated with gestational age at birth. This work adds to the body of evidence of the impact of early term birth and highlights the importance of considering the effect of gestational age at birth in future neuroimaging studies including term-born babies.
