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Preterm birth, socioeconomic status, and white matter development across childhood

Katie Mckinnon1, Manuel Blesa Cábez1,2, Melissa Thye2

  • 1Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, UK.

Medrxiv : the Preprint Server for Health Sciences
|June 30, 2025
PubMed

Insights

Preterm birth and socioeconomic status (SES) impact brain development. The influence of SES on white matter microstructure shifts from family-based measures to neighborhood-based measures by age five.

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Medical Imaging

Background:

  • Preterm birth and socioeconomic status (SES) are known factors influencing early brain development.
  • The long-term, combined effects of gestational age (GA) and SES on white matter microstructure remain unclear.

Purpose of the Study:

  • To investigate the impact of gestational age (GA) and socioeconomic status (SES) on white matter microstructure.
  • To examine these effects in both the neonatal period and at five years of age.

Main Methods:

  • Diffusion MRI was used to assess white matter microstructure (fractional anisotropy - FA).
  • Participants included preterm and term infants, with follow-up imaging at five years.
  • Associations between GA, SES (maternal education, Scottish Index of Multiple Deprivation - SIMD), and FA were analyzed, including GA×SES interactions.

Main Results:

  • In preterm neonates, higher GA and maternal education correlated with higher FA.
  • GA-SES interactions showed that GA-FA associations were influenced by both maternal education and SIMD.
  • At five years, the association between GA and FA was primarily dependent on SIMD, not maternal education.
  • Term infants showed an association between lower SES and higher FA only in the neonatal period.

Conclusions:

  • Both preterm birth and SES significantly shape brain development from birth through five years.
  • The primary measure of SES influencing white matter microstructure in preterm infants transitions from family-level (maternal education) to neighborhood-level (SIMD) by age five.
  • Interventions to address social inequalities' impact on development may need to adapt as children age.
Abstract

Keywords:
MRIPreterm birthchildneonatesocioeconomic statuswhite matter

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