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Brain Volumes and Abnormalities in Adults Born Preterm at Very Low Birth Weight

Juho Kuula1, Juha Martola2, Antti Hakkarainen2

  • 1HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.

The Journal of Pediatrics
|March 18, 2022
PubMed

Insights

Adults born preterm at very low birth weight show more brain abnormalities and smaller gray matter volumes than their siblings. These findings highlight long-term neurological effects of extreme prematurity.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Radiology

Background:

  • Preterm birth, especially at very low birth weight (<1500g), poses significant risks for neurodevelopmental outcomes.
  • Long-term structural and volumetric brain changes in adults born very preterm are not fully understood.
  • Sibling-controlled studies offer a unique approach to minimize genetic and environmental confounds.

Purpose of the Study:

  • To evaluate radiographic brain abnormalities in adults born very low birth weight (VLBW).
  • To investigate volumetric differences in brain structures between VLBW adults and their term-born siblings.
  • To identify specific brain regions affected by extreme preterm birth.

Main Methods:

  • Recruitment of 79 adult same-sex sibling pairs, with one VLBW preterm and one term-born sibling.
  • Acquisition of 3-T brain MRI scans for 78 VLBW participants and 72 siblings.
  • Neuroradiologist review for abnormalities and FreeSurfer software for volumetric analysis, analyzed via linear mixed models.

Main Results:

  • Higher prevalence of structural brain abnormalities in VLBW adults (37%) compared to siblings (13%), notably periventricular leukomalacia (15% vs 3%).
  • VLBW group exhibited smaller absolute brain volumes (-0.4 SD).
  • Reduced gray matter (-0.2 SD), enlarged ventricles (1.5 SD), and smaller volumes in thalami, caudate nuclei, hippocampus, and pallidum were observed in VLBW individuals. No significant white matter volume difference was found.

Conclusions:

  • Adults born very low birth weight have a significantly higher incidence of brain abnormalities compared to their term-born siblings.
  • VLBW individuals demonstrate reduced overall brain volume and specifically smaller gray matter volumes.
  • These findings underscore the lasting impact of extreme prematurity on brain development and structure.
Abstract

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