title: Association between preterm brain injury and exposure to chorioamnionitis during fetal life.
abstract: Preterm infants are susceptible to inflammation-induced white matter injury but the exposures that lead to this are uncertain. Histologic chorioamnionitis (HCA) reflects intrauterine inflammation, can trigger a fetal inflammatory response, and is closely associated with premature birth. In a cohort of 90 preterm infants with detailed placental histology and neonatal brain magnetic resonance imaging (MRI) data at term equivalent age, we used Tract-based Spatial Statistics (TBSS) to perform voxel-wise statistical comparison of fractional anisotropy (FA) data and computational morphometry analysis to compute the volumes of whole brain, tissue compartments and cerebrospinal fluid, to test the hypothesis that HCA is an independent antenatal risk factor for preterm brain injury. Twenty-six (29%) infants had HCA and this was associated with decreased FA in the genu, cingulum cingulate gyri, centrum semiovale, inferior longitudinal fasciculi, limbs of the internal capsule, external capsule and cerebellum (p < 0.05, corrected), independent of degree of prematurity, bronchopulmonary dysplasia and postnatal sepsis. This suggests that diffuse white matter injury begins in utero for a significant proportion of preterm infants, which focuses attention on the development of methods for detecting fetuses and placentas at risk as a means of reducing preterm brain injury.
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
authors.forename: Devasuda
authors.initials: D
authors.lastname: Anblagan
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Rozalia
authors.initials: R
authors.lastname: Pataky
authors.affiliation: Department of Pathology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Evans
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Telford
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Serag
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sparrow
authors.affiliation: Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Chinthika
authors.initials: C
authors.lastname: Piyasena
authors.affiliation: Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.|Clinical Research Imaging Centre, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
authors.forename: Scott I
authors.initials: SI
authors.lastname: Semple
authors.affiliation: Department of Radiology, Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh, EH9 1LF, UK.
authors.forename: Alastair Graham
authors.initials: AG
authors.lastname: Wilkinson
authors.affiliation: Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Bastin
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.|Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK.
authors.forename: James P
authors.initials: JP
authors.lastname: Boardman
mesh_terms: D016880:Anisotropy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D001997:Bronchopulmonary Dysplasia / Q000000981:diagnostic imaging* / Q000209:etiology; D002821:Chorioamnionitis / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D008297:Male; D000071074:Neonatal Sepsis / Q000000981:diagnostic imaging* / Q000209:etiology; D011247:Pregnancy