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Trends in Term-Equivalent Age Brain Volumes in Infants Born Across the Gestational Age Spectrum
Anouk S Verschuur1,2,3, Gerda van Wezel-Meijler4, Selma Low5
1Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands.
Insights
Gestational age at birth impacts brain development. Lower gestational age is linked to smaller brain tissue volumes and larger cerebrospinal fluid volumes at term-equivalent age, affecting neurodevelopment in preterm infants.
Area of Science:
- Neonatal neuroscience
- Developmental neuroimaging
- Perinatal medicine
Background:
- Understanding preterm birth's impact on early brain development is crucial for neuroprotection.
- Current knowledge gaps hinder personalized neuroprotective strategies for preterm infants.
Purpose of the Study:
- To assess the effect of gestational age (GA) at birth on brain volumes at term-equivalent age (TEA).
- To investigate brain development in infants born across the GA spectrum without overt brain injury.
Main Methods:
- 3T brain MRI was performed on infants (25-40 weeks GA) around TEA (40-46 weeks postmenstrual age).
- Brain regions and volumes were segmented using MANTiS, with quality control.
- Linear regression analyzed the relationship between GA and brain volumes, controlling for postmenstrual age.
Main Results:
- Higher GA was significantly associated with lower cerebrospinal fluid and amygdala volumes.
- No significant relation was found between GA and other measured brain volumes.
- Positive trends indicated larger brain tissue volumes with increasing GA.
Conclusions:
- Gestational age independently influences brain volumes at TEA, irrespective of brain lesions.
- Lower GA correlates with reduced brain tissue volumes and increased cerebrospinal fluid volume.
- Preterm birth exposures may impact early brain growth, contributing to neurodevelopmental challenges.
Purpose:
Our understanding of the influence of preterm birth and related perinatal exposures on early brain development is limited, hampering personalized optimization of neuroprotective strategies. This study assesses the effect of gestational age (GA) at birth on brain volumes at term-equivalent age (TEA) in infants without overt brain injury born across the GA spectrum.
Methods:
A cohort of infants born across the GA spectrum (25-40 weeks' gestation) underwent 3T brain MRI around TEA (40-46 weeks postmenstrual age). Eight brain regions, intracranial and total tissue volumes were segmented using MANTiS (morphologically adaptive neonatal tissue segmentation toolbox). Segmentations were visually quality-checked and excluded if segmentation failed. Absolute TEA volume in relation to GA was assessed using univariate and multivariate (correction for postmenstrual age) linear regression analysis. Statistical significance was set at p < 0.05. Post hoc scatter plots of brain volumes relative to intracranial volumes were created.
Results:
Fifty infants were included (mean GA = 35.0 [SD = 3.3, range = 25.7-40.1] weeks). A higher GA at birth was significantly related to lower cerebrospinal fluid (p = 0.004) and amygdala (p = 0.02) volumes; no significant relation was found between GA and other volumes. Post hoc analyses showed positive trends between GA and several brain structures, including total brain tissue, cortical gray matter, deep gray matter, hippocampus, cerebellum and brainstem volumes.
Conclusions:
Our results suggest that GA has an effect on TEA brain volumes that is independent of brain lesions, with lower GA being associated with smaller brain tissue volumes and significantly larger cerebrospinal fluid volume. Preterm birth and related exposures may thus affect early brain growth and contribute to neurodevelopmental challenges encountered by preterm-born children.
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