title: Cerebral structure and metabolism and long-term outcome in small-for-gestational-age preterm neonates.
abstract: In the present study, we compared brain development and metabolism of small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants using proton magnetic resonance spectroscopy ((1)H-MRS). We tested the hypothesis that intrauterine growth retardation caused by placental insufficiency is associated with changes in cerebral metabolism and is followed by an adverse neurodevelopmental outcome at the age of 2 y. Twenty-six AGA and 14 SGA (birth weight <P 2.3) preterm infants with no major ultrasound abnormalities were enrolled prospectively. At 32 and 41 wk postmenstrual age, (1)H-MRS and magnetic resonance imaging were performed. For (1)H-MRS, a volume of interest was placed in the basal ganglia and in the periventricular white matter. Using echo times of 31 and 144 ms N-acetylaspartate/choline (NAA/Cho), lactate/Cho, myo-inositol/Cho (mI/Cho), and glutamate-glutamine-gamma-aminobutyric acid/Cho (Glx/Cho) ratios were compared between AGA and SGA groups. Griffiths' developmental quotient (DQ) values were assessed at 24 mo corrected age. Griffiths' DQ (AGA, 104 +/- 10; SGA, 99 +/- 9) and brain development assessed using magnetic resonance imaging showed no significant differences between both AGA and SGA groups, and NAA/Cho, Lac/Cho, mI/Cho, and Glx/Cho ratios were not significantly different between the groups. NAA/Cho ratios increased from 32 to 41 wk, whereas mI/Cho ratios decreased in both groups. No differences in cerebral metabolism, brain development, and DQ values between AGA and severely SGA infants could be demonstrated.
authors.affiliation: Wilhelmina Children's Hospital/University Medical Center Utrecht, Department of Neonatology, Room KE 04.123.1, Lundlaan 6, 3584 EA Utrecht, The Netherlands. F.Groenendaal@WKZ.AZU.NL
authors.forename: Ariadne M
authors.initials: AM
authors.lastname: Roelants-van Rijn
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
authors.forename: Robert H
authors.initials: RH
authors.lastname: Stigter
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
mesh_terms: D001724:Birth Weight; D002540:Cerebral Cortex / Q000002:abnormalities / Q000033:anatomy & histology / Q000254:growth & development / Q000378:metabolism; D005260:Female; D005317:Fetal Growth Retardation; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight / Q000378:metabolism*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D011247:Pregnancy; D016896:Treatment Outcome