Associations of Newborn Brain Magnetic Resonance Imaging with Long-Term Neurodevelopmental Impairments in Very Preterm Children

Peter J Anderson¹, Karli Treyvaud², Jeffrey J Neil³, Jeanie L Y Cheong⁴, Rodney W Hunt⁵, Deanne K Thompson⁶, Katherine J Lee⁶, Lex W Doyle⁷, Terrie E Inder⁸

Affiliations

¹ Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. Electronic address: peter.j.anderson@monash.edu.
² Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Psychology and Counseling, La Trobe University, Melbourne, Victoria, Australia.
³ Department of Neurology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Harvard University, Boston, MA.
⁴ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Victoria, Australia; Newborn Intensive Care, The Royal Women's Hospital, Melbourne, Victoria, Australia.
⁵ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Neonatal Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.
⁶ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Victoria, Australia; Newborn Intensive Care, The Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁸ Harvard Medical School, Harvard University, Boston, MA; Pediatric Newborn Medicine, The Brigham and Women's Hospital, Boston, MA.

PMID: 28583705
PMCID: PMC5533625
DOI: 10.1016/j.jpeds.2017.04.059

Associations of Newborn Brain Magnetic Resonance Imaging with Long-Term Neurodevelopmental Impairments in Very Preterm Children

Peter J Anderson et al. J Pediatr. 2017 Aug.

. 2017 Aug:187:58-65.e1.

doi: 10.1016/j.jpeds.2017.04.059. Epub 2017 Jun 2.

Authors

Peter J Anderson¹, Karli Treyvaud², Jeffrey J Neil³, Jeanie L Y Cheong⁴, Rodney W Hunt⁵, Deanne K Thompson⁶, Katherine J Lee⁶, Lex W Doyle⁷, Terrie E Inder⁸

Affiliations

¹ Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. Electronic address: peter.j.anderson@monash.edu.
² Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Psychology and Counseling, La Trobe University, Melbourne, Victoria, Australia.
³ Department of Neurology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Harvard University, Boston, MA.
⁴ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Victoria, Australia; Newborn Intensive Care, The Royal Women's Hospital, Melbourne, Victoria, Australia.
⁵ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Neonatal Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.
⁶ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁷ Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Victoria, Australia; Newborn Intensive Care, The Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁸ Harvard Medical School, Harvard University, Boston, MA; Pediatric Newborn Medicine, The Brigham and Women's Hospital, Boston, MA.

PMID: 28583705
PMCID: PMC5533625
DOI: 10.1016/j.jpeds.2017.04.059

Abstract

Objective: To determine the relationship between brain abnormalities on newborn magnetic resonance imaging (MRI) and neurodevelopmental impairment at 7 years of age in very preterm children.

Study design: A total of 223 very preterm infants (<30 weeks of gestation or <1250 g) born at Melbourne's Royal Women's Hospital had a brain MRI scan at term equivalent age. Scans were scored using a standardized system that assessed structural abnormality of cerebral white matter, cortical gray matter, deep gray matter, and cerebellum. Children were assessed at 7 years on measures of general intelligence, motor functioning, academic achievement, and behavior.

Results: One hundred eighty-six very preterm children (83%) had both an MRI at term equivalent age and a 7-year follow-up assessment. Higher global brain, cerebral white matter, and deep gray matter abnormality scores were related to poorer intelligence quotient (IQ) (Ps < .01), spelling (Ps < .05), math computation (Ps < .01), and motor function (Ps < .001). Higher cerebellum abnormality scores were related to poorer IQ (P = .001), math computation (P = .018), and motor outcomes (P = .001). Perinatal, neonatal, and social confounders had little effect on the relationships between the MRI abnormality scores and outcomes. Moderate-severe global abnormality on newborn MRI was associated with a reduction in IQ (-6.9 points), math computation (-7.1 points), and motor (-1.9 points) scores independent of the other potential confounders.

Conclusions: Structured evaluation of brain MRI at term equivalent is predictive of outcome at 7 years of age, independent of clinical and social factors.

Keywords: brain imaging; brain pathology; outcome; prematurity.

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Conflict of interest statement

The authors have no conflicts of interest.

Comment in

To screen preterm brains at term or not: that is the question.
Fisher PG. Fisher PG. J Pediatr. 2017 Aug;187:4. doi: 10.1016/j.jpeds.2017.06.029. J Pediatr. 2017. PMID: 28750765 No abstract available.
Value-based care: the preference of outcome over prediction.
Ho T, Dukhovny D, Zupancic JAF, Pursley DM. Ho T, et al. J Pediatr. 2018 May;196:330-331. doi: 10.1016/j.jpeds.2018.01.016. Epub 2018 Mar 1. J Pediatr. 2018. PMID: 29502876 No abstract available.
Reply.
Inder TE, Doyle LW, Cheong JLY, Anderson PJ. Inder TE, et al. J Pediatr. 2018 May;196:331. doi: 10.1016/j.jpeds.2018.01.018. Epub 2018 Mar 5. J Pediatr. 2018. PMID: 29519538 No abstract available.

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Associations of Newborn Brain Magnetic Resonance Imaging with Long-Term Neurodevelopmental Impairments in Very Preterm Children

Affiliations

Associations of Newborn Brain Magnetic Resonance Imaging with Long-Term Neurodevelopmental Impairments in Very Preterm Children

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical