Moderate and late preterm infants exhibit widespread brain white matter microstructure alterations at term-equivalent age relative to term-born controls.
Despite the many studies documenting cerebral white matter microstructural alterations associated with very preterm birth (<32 weeks' gestation), there is a dearth of similar research in moderate and late preterm infants (born 32-36 weeks' gestation), who experience higher rates of neurodevelopmental delays than infants born at term (≥ 37 weeks' gestation). We therefore aimed to determine whether whole brain white matter microstructure differs between moderate and late preterm infants and term-born controls at term-equivalent age, as well as to identify potential perinatal risk factors for white matter microstructural alterations in moderate and late preterm infants. Whole brain white matter microstructure was studied in 193 moderate and late preterm infants and 83 controls at term-equivalent age by performing Tract-Based Spatial Statistics analysis of diffusion tensor imaging data. Moderate and late preterm infants had lower fractional anisotropy and higher mean, axial and radial diffusivities compared with controls in nearly 70% of the brain's major white matter fiber tracts. In the moderate and late preterm group, being born small for gestational age and male sex were associated with lower fractional anisotropy, largely within the optic radiation, corpus callosum and corona radiata. In conclusion, moderate and late preterm infants exhibit widespread brain white matter microstructural alterations compared with controls at term-equivalent age, in patterns consistent with delayed or disrupted white matter microstructural development. These findings may underpin some of the neurodevelopmental delays observed in moderate and late preterm children.
Murdoch Childrens Research Institute, Melbourne, Australia. claire.armstrongkell@mcri.edu.au.|Victorian Infant Brain Study (VIBeS), Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia. claire.armstrongkell@mcri.edu.au.
Claire E
CE
Kelly
Murdoch Childrens Research Institute, Melbourne, Australia.|Royal Women's Hospital, Melbourne, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.
Jeanie L Y
JL
Cheong
Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Lillian
L
Gabra Fam
Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
Alexander
A
Leemans
Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Marc L
ML
Seal
Murdoch Childrens Research Institute, Melbourne, Australia.|Royal Women's Hospital, Melbourne, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Lex W
LW
Doyle
Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Peter J
PJ
Anderson
Murdoch Childrens Research Institute, Melbourne, Australia.|Royal Women's Hospital, Melbourne, Australia.|Department of Physiotherapy, University of Melbourne, Melbourne, Australia.
Alicia J
AJ
Spittle
Murdoch Childrens Research Institute, Melbourne, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
Deanne K
DK
Thompson
D001921:Brain / Q000000981:diagnostic imaging* / Q000254:growth & development; D002658:Developmental Disabilities / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000254:growth & development; D011446:Prospective Studies; D012307:Risk Factors; D066127:White Matter / Q000000981:diagnostic imaging* / Q000254:growth & development
Diffusion tensor imaging; Late preterm; Magnetic resonance imaging; Neonate; Preterm birth; Tract-based spatial statistics