Intrauterine growth restriction (IUGR) is the second leading cause of new-born death. Surviving infants display long-lasting problems, encompassing cognitive and behavioural domains. AIMS: To study the effect of IUGR on very preterm (VPT) infants’ brain volumes on MRI scans at 40 weeks and cognitive and behavioural outcomes at 22 months of life. METHOD: Participants were 35 IUGR and 249 appropriate for gestational age (AGA) VPT infants (GA < 33 weeks) enrolled in the Evaluation of Preterm Imaging Study. Structural T2 images were acquired at term equivalent. Cognitive development at 22 months was assessed with the Bayley Scales for Infant Development, behavioral outcome was rated with the Modified-CHecklist for Autism in Toddlers (MCHAT). RESULTS: At 40 weeks term-equivalent, IUGR infants displayed increased grey matter (GM) in right: supramarginal gyrus, gyrus rectus, superior temporal gyrus compared to preterm AGA infants. Decreased GM volumes was observed in left precentral gyrus and frontal middle orbital gyrus and in right hippocampus and fusiform gyrus. At 22 months, IUGR performed significantly lower on cognitive (IUGR: 90.81 ± 9.3 vs AGA: 95.86 ± 11.98; t(45.1) = -2.72, p < .05), motor (IUGR: 94.61 ± 8.98 vs AGA: 98.26 ± 9.15; t(39.1) = -2.11, p < .05) and language (IUGR: 88.32 ± 15.14 vs AGA: 94.07 ± 16.12; t(40.1) = -1.96, p = .05) tests compared to preterm AGA toddlers. They were also more likely to score positive on the M-CHAT (IUGR: 50% vs AGA: 23.32%; X2(1)= 8.87, p < .01). Whole-group associations with cognitive outcome and positive M-CHAT screening were observed for right supramarginal gyrus, left precentral gyrus and right gyrus rectus. CONCLUSION: Brain volumes alterations observed in IUGR developing brain are associated with cognitive outcome in VPT infants. These findings have implications for identifying antenatal impacts on child growth and developing neuroprotective strategies to constrain the effects of atypical brain volumes on later outcomes.

Specific contributions of gray matter alteration to neurodevelopment in antenatally growth restricted very preterm infants

Sacchi C;CESANO, MICHELA;Nosarti C.
2019

Abstract

Intrauterine growth restriction (IUGR) is the second leading cause of new-born death. Surviving infants display long-lasting problems, encompassing cognitive and behavioural domains. AIMS: To study the effect of IUGR on very preterm (VPT) infants’ brain volumes on MRI scans at 40 weeks and cognitive and behavioural outcomes at 22 months of life. METHOD: Participants were 35 IUGR and 249 appropriate for gestational age (AGA) VPT infants (GA < 33 weeks) enrolled in the Evaluation of Preterm Imaging Study. Structural T2 images were acquired at term equivalent. Cognitive development at 22 months was assessed with the Bayley Scales for Infant Development, behavioral outcome was rated with the Modified-CHecklist for Autism in Toddlers (MCHAT). RESULTS: At 40 weeks term-equivalent, IUGR infants displayed increased grey matter (GM) in right: supramarginal gyrus, gyrus rectus, superior temporal gyrus compared to preterm AGA infants. Decreased GM volumes was observed in left precentral gyrus and frontal middle orbital gyrus and in right hippocampus and fusiform gyrus. At 22 months, IUGR performed significantly lower on cognitive (IUGR: 90.81 ± 9.3 vs AGA: 95.86 ± 11.98; t(45.1) = -2.72, p < .05), motor (IUGR: 94.61 ± 8.98 vs AGA: 98.26 ± 9.15; t(39.1) = -2.11, p < .05) and language (IUGR: 88.32 ± 15.14 vs AGA: 94.07 ± 16.12; t(40.1) = -1.96, p = .05) tests compared to preterm AGA toddlers. They were also more likely to score positive on the M-CHAT (IUGR: 50% vs AGA: 23.32%; X2(1)= 8.87, p < .01). Whole-group associations with cognitive outcome and positive M-CHAT screening were observed for right supramarginal gyrus, left precentral gyrus and right gyrus rectus. CONCLUSION: Brain volumes alterations observed in IUGR developing brain are associated with cognitive outcome in VPT infants. These findings have implications for identifying antenatal impacts on child growth and developing neuroprotective strategies to constrain the effects of atypical brain volumes on later outcomes.
2019
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3304729
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