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Preterm Sex Differences in Neurodevelopment and Brain Development from Early Life to 8 Years of Age

Rhandi Christensen1, Vann Chau1, Anne Synnes2

  • 1Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, ON, Canada.

The Journal of Pediatrics
|September 1, 2024
PubMed

Insights

Preterm males show poorer cognitive and motor outcomes compared to females, potentially due to white matter differences. Sex influences how preterm infants respond to brain injury and pain.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Neonatology

Background:

  • Preterm birth impacts neurodevelopmental outcomes.
  • Sex-based differences in brain development and vulnerability are increasingly recognized.

Purpose of the Study:

  • To investigate sex differences in neurodevelopmental trajectories and brain development in preterm infants up to 8 years of age.
  • To explore how sex moderates the effects of early adversity (brain injury, pain) on neurodevelopment.

Main Methods:

  • Prospective cohort study of very preterm infants (24-32 weeks gestation) followed to 8 years.
  • Standardized neurodevelopmental assessments and serial brain MRI scans.
  • Multivariable generalized estimating equations used to analyze relationships between sex, brain injury, pain, fractional anisotropy, and outcomes.

Main Results:

  • Males exhibited lower cognitive scores and greater motor impairment compared to females.
  • Male sex was associated with reduced white matter fractional anisotropy.
  • Sex moderated the impact of severe brain injury and early pain on neurodevelopmental outcomes.

Conclusions:

  • Preterm males face greater neurodevelopmental challenges (cognition, motor skills) than females, possibly linked to white matter maturation differences.
  • Sex-specific responses to early-life adversity, including brain injury and pain, were observed in preterm infants.
Abstract

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