Early growth in brain volume is preserved in the majority of preterm infants.
OBJECTIVE
Preterm infants have reduced cerebral tissue volumes in adolescence. This study addresses the question: Is reduced global brain growth in the neonatal period inevitable after premature birth, or is it associated with specific medical risk factors?


METHODS
Eighty-nine preterm infants at term equivalent age without focal parenchymal brain lesions were studied with 20 full-term control infants. Using a deformation-based morphometric approach, we transformed images to a reference anatomic space, and we used the transformations to calculate whole-brain volume and ventricular volume for each subject. Patterns of volume difference were correlated with clinical data.


RESULTS
Cerebral volume is not reduced compared with term born control infants (p = 0.765). Supplemental oxygen requirement at 28 postnatal days is associated with lower cerebral tissue volume at term (p < 0.001), but there were no significant differences in cerebral volumes attributable to perinatal sepsis (p = 0.515) and quantitatively defined diffuse white matter injury (p = 0.183). As expected, the ventricular system is significantly larger in preterm infants at term equivalent age compared with term control infants (p < 0.001).


CONCLUSIONS
Cerebral volume is not reduced during intensive care for the majority of preterm infants, but prolonged supplemental oxygen dependence is a risk factor for early attenuation of global brain growth. The reduced cerebral tissue volume seen in adolescents born preterm does not appear to be an inevitable association of prematurity, but rather caused by either specific disease during intensive care or factors operating beyond the neonatal period.
Boardman
James P
JP
Imaging Sciences Department, Medical Research Council Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, United Kingdom. j.boardman@imperial.ac.uk
Counsell
Serena J
SJ
Rueckert
Daniel
D
Hajnal
Jo V
JV
Bhatia
Kanwal K
KK
Srinivasan
Latha
L
Kapellou
Olga
O
Aljabar
Paul
P
Dyet
Leigh E
LE
Rutherford
Mary A
MA
Allsop
Joanna M
JM
Edwards
A David
AD
D001921:Brain / Q000033:anatomy & histology / Q000254:growth & development*; D002552:Cerebral Ventricles / Q000033:anatomy & histology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D010100:Oxygen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors
D010100:Oxygen