title: Bronchopulmonary dysplasia is associated with delayed structural brain maturation in preterm infants.
abstract: BACKGROUND
  In recent years, cerebral magnetic resonance imaging (MRI) has been increasingly used to depict the wide spectrum of preterm brain injury. Furthermore, it has already been demonstrated by MRI at term-equivalent age (TEA) that preterm infants show delayed brain maturation as compared to term infants, and this delay has been related to neurobehavioral outcome.
  
  
  OBJECTIVE
  The aim of the current study was to investigate the influence of prevalent neonatal risk factors for adverse outcome on structural brain maturation in very preterm infants at TEA.
  
  
  METHODS
  One hundred and thirty very preterm infants born at a mean gestational age of 29.7 weeks were included. MRI was performed at TEA and given a validated 'total maturation score'. Brain maturation scores were compared with neonatal data.
  
  
  RESULTS
  In univariate analysis, bronchopulmonary dysplasia (BPD), late-onset sepsis and retinopathy of prematurity were significantly associated with delayed brain maturation. Furthermore, infants with delayed maturation had been ventilated significantly longer and more often suffered from severe arterial hypotension. In multivariate analysis, BPD remained significant as predictor of delayed brain maturation.
  
  
  CONCLUSIONS
  This study is the first to show that delayed structural brain maturation as evaluated by MRI at TEA is preceded by BPD, which is known to be a predictor of adverse outcome in preterm infants. This finding adds further evidence to show that adverse outcome in preterm infants may have additional neural correlates that exceed common brain injury.
authors: Neonatology, Department of Paediatrics II, Innsbruck Medical University, Innsbruck, Austria.
authors: Vera
authors: V
authors: Neubauer
authors: Daniel
authors: D
authors: Junker
authors: Elke
authors: E
authors: Griesmaier
authors: Michael
authors: M
authors: Schocke
authors: Ursula
authors: U
authors: Kiechl-Kohlendorfer
mesh_terms: D001921:Brain / Q000254:growth & development / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications; D001997:Bronchopulmonary Dysplasia / Q000150:complications*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors