Bruno Christie J, Bengani Shreyans, Gomes William A, Brewer Mariana, Vega Melissa, Xie Xianhong, Kim Mimi, Fuloria Mamta
Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
Neonatology. 2017;111(4):317-323. doi: 10.1159/000453576. Epub 2017 Jan 11.
Preterm infants are at risk for neurodevelopmental impairment. Intrauterine growth restriction (IUGR) further increases this risk. Brain imaging studies are often utilized at or near term-equivalent age to determine later prognosis.
To evaluate the association between intrauterine growth and regional brain volume on MRI scans performed in preterm infants at or near term-equivalent age.
This is a retrospective case-control study of 24 infants born at gestational age ≤30 weeks and cared for in a large, inner-city, academic neonatal intensive-care unit from 2012 to 2013. Each IUGR infant was matched with 1-2 appropriate for gestational age (AGA) infants who served as controls. Predischarge MRI scans routinely obtained at ≥36 weeks' adjusted age were analyzed for regional brain volumetric differences. We examined the association between IUGR and thalamic, basal ganglion, and cerebellar brain volumes in these preterm infants.
Compared to AGA infants, IUGR infants had a smaller thalamus (7.88 vs. 5.87 mL, p = 0.001) and basal ganglion (8.87 vs. 6.92 mL, p = 0.002) volumes. There was no difference in cerebellar volumes between the two study groups. Linear regression analyses revealed similar trends in the associations between IUGR and brain volumes after adjusting for sex, gestational age at birth, and postconceptual age and weight at MRI.
Thalamus and basal ganglion volumes are reduced in growth-restricted preterm infants. These differences may preferentially impact neurodevelopmental outcomes. Further research is needed to explore these relationships.
早产儿有神经发育障碍的风险。宫内生长受限（IUGR）会进一步增加这种风险。脑成像研究通常在足月等效年龄或接近该年龄时进行，以确定后期预后。
评估在足月等效年龄或接近该年龄的早产儿中，宫内生长与MRI扫描显示的脑区体积之间的关联。
这是一项回顾性病例对照研究，研究对象为2012年至2013年在一个大型市中心学术性新生儿重症监护病房接受治疗的24例胎龄≤30周的婴儿。每例IUGR婴儿与1 - 2例胎龄相称（AGA）的婴儿配对作为对照。对在矫正年龄≥36周时常规获得的出院前MRI扫描进行分析，以比较脑区体积差异。我们研究了这些早产儿中IUGR与丘脑、基底神经节和小脑体积之间的关联。
与AGA婴儿相比，IUGR婴儿的丘脑体积（7.88 vs. 5.87 mL，p = 0.001）和基底神经节体积（8.87 vs. 6.92 mL，p = 0.002）较小。两个研究组的小脑体积没有差异。线性回归分析显示，在调整性别、出生时的胎龄、孕龄和MRI时的体重后，IUGR与脑体积之间的关联有相似趋势。
生长受限的早产儿丘脑和基底神经节体积减小。这些差异可能会对神经发育结局产生优先影响。需要进一步研究来探索这些关系。
