Differential effects of intrauterine growth restriction on brain structure and development in preterm infants: a magnetic resonance imaging study.
Previous evidence suggests that preterm newborns with intrauterine growth restriction (IUGR) have specific neurostructural and neurodevelopmental anomalies, but it is unknown whether these effects persist in early childhood. We studied a sample of 18 preterm IUGR, 15 preterm AGA - born between 26 and 34 weeks of gestational age (GA) - and 15 healthy born-term infants. Infants were scanned at 12 months corrected age (CA), in a 3T scanner, without sedation. Analyses were made by automated lobar volumetry and voxel-based morphometry (VBM). The neurodevelopmental outcome was assessed in all subjects at 18 months CA with the Bayley Scale for Infant and Toddler Development, third edition. IUGR infants had reduced relative volumes for the insular and temporal lobes. According to VBM, IUGR infants had bilateral reduced gray matter (GM) in the temporal, parietal, frontal, and insular regions compared with the other groups. IUGR infants had increased white matter (WM) in temporal regions compared to the AGA group and in frontal, parietal, occipital, and insular regions compared to the term group. They also showed decreased WM in the cerebellum and a non-significant trend in the hippocampus compared to term infants. IUGR infants had reduced neurodevelopmental scores, which were positively correlated with GM in various regions. These data suggest that the IUGR induces a distinct brain pattern of structural changes that persist at 1 year of life and are associated with specific developmental difficulties.
Department of Maternal-Fetal Medicine, Hospital Clínic, Universidad de Barcelona, Calle Sabino de Arana 1, 08028, Barcelona, Spain. fpadilla@clinic.ub.es
Nelly
N
Padilla
Carles
C
Falcón
Magdalena
M
Sanz-Cortés
Francesc
F
Figueras
Núria
N
Bargallo
Fátima
F
Crispi
Elisenda
E
Eixarch
Angela
A
Arranz
Francesc
F
Botet
Eduard
E
Gratacós
D001921:Brain / Q000002:abnormalities* / Q000254:growth & development*; D002531:Cerebellum / Q000002:abnormalities / Q000254:growth & development; D002540:Cerebral Cortex / Q000002:abnormalities / Q000254:growth & development; D002658:Developmental Disabilities / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005317:Fetal Growth Retardation / Q000473:pathology* / Q000503:physiopathology; D005865:Gestational Age; D006624:Hippocampus / Q000002:abnormalities / Q000254:growth & development; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008279:Magnetic Resonance Imaging / Q000379:methods; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D011247:Pregnancy; D012016:Reference Values