Related Experiment Video
Updated: Jun 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Contrasting neonatal brain morphometry and its impact on neurodevelopmental outcome between preterm birth and
Siân Wilson1,2,3,4, Barat Gal-Er1, Daniel Cromb1
1Research Department of Early Life Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.
Insights
Infants with congenital heart disease (CHD) and prematurity show distinct brain structures, not shared ones. Neonatal brain differences predict later development in preterm infants but not in those with CHD.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Congenital heart disease (CHD) and prematurity are major causes of infant mortality and morbidity.
- Both conditions are linked to neurological issues, including brain injury and developmental impairments.
- Hypotheses suggest shared brain structural differences, but empirical evidence is lacking.
Purpose of the Study:
- To compare neonatal brain structure in infants with CHD and prematurity.
- To analyze the relationship between brain structure and neurodevelopmental outcomes.
- To investigate potential shared or distinct neurobiological pathways in these high-risk groups.
Main Methods:
- Retrospective, longitudinal, case-control study of 602 T2-weighted infant brain MRIs (37-44 weeks postmenstrual age).
- Cohort included early preterm, late preterm, CHD infants, and term-born controls.
- Structural covariance networks were analyzed to capture brain morphometry variations.
Main Results:
- Distinct neonatal brain structural profiles were identified in CHD and preterm infants, with minimal overlap.
- Neonatal brain morphology variation significantly predicted neurodevelopment in preterm infants and controls at 18-24 months.
- This association between brain morphology and neurodevelopment was absent in infants with CHD.
Conclusions:
- Infants with CHD and preterm infants exhibit distinct neonatal brain structural differences.
- Neurobiological pathways leading to adverse outcomes appear divergent between CHD and preterm infants.
- Brain structure-neurodevelopment associations differ significantly between these high-risk infant populations.
Abstract:
Congenital heart disease (CHD) and prematurity are leading causes of infant mortality and morbidity. Both groups of infants share certain common neurological sequalae, such as increased risk of neonatal brain injury and neurodevelopmental impairments later in life, leading to hypotheses that there may be shared underlying structural differences in the infant brain. However, there is no empirical evidence to support this, and our objective with this study was to compare and contrast neonatal brain structure between at-risk infant groups, then analyse their relationship with neurodevelopmental outcome. We carried out a retrospective, longitudinal, case-control analysis of 602 T2-weighted infant brain MRIs, acquired between 37 and 44 weeks postmenstrual age (PMA). The cohort comprised early preterm (n = 60), late preterm (n = 67), infants with congenital heart disease (CHD; n = 116), and term-born controls from the Developing Human Connectome Project (n = 360). We analyse structural covariance networks, a data-driven extraction of co-maturing neuroanatomical structures, capturing the variation in brain morphometry for each infant. We found distinct structural profiles in CHD and preterm infants, with minimal overlap observed between groups. A subset (n = 428) returned for neurodevelopmental follow-up at 18-24 months, and we explored the association with Bayley-III cognitive and motor scores. We found that variation in neonatal brain morphology is a significant predictor of toddler neurodevelopment in preterm infants and controls, but this association is absent in CHD. These findings suggest divergent neurobiological pathways may underlie adverse outcomes in these high-risk infants.
