PET Center, Turku University Hospital, Turku, Finland.
Department of Medical physics, Turku University Hospital, Turku, Finland.
Acta Paediatr. 2017 Oct;106(10):1600-1607. doi: 10.1111/apa.13954. Epub 2017 Jul 14.
This study evaluated the role of preterm birth and fetal growth restriction on white matter maturation in schoolchildren without any severe neurodevelopmental impairment.
The study group comprised 56 very preterm children and 21 term children born between November 1998 and November 2002 at Oulu University Hospital, Finland. The mean gestational age of the preterm children was 28.7 (24.1-31.9) weeks. All children underwent diffusion tensor imaging at a mean age of 9.0 (8.6-9.6) years. Voxel-wise statistical analyses of the imaging data were carried out using tract-based spatial statistics.
Preterm children with fetal growth restriction had lower fractional anisotropy and higher radial diffusivity than term controls (p < 0.05), bilaterally in several white matter areas. Preterm children without fetal growth restriction had higher mean diffusivity and axial diffusivity than term controls (p < 0.05) in analogous areas, but more asymmetrically.
Preterm children had microstructural differences in white matter, compared to term-born children at a mean age of nine, and those with poor fetal growth showed widespread changes in white matter maturation compared to term-born children. Fetal growth and prematurity seemed to affect white matter maturation in a way that was still visible at that age.
本研究旨在评估早产儿和胎儿生长受限对无严重神经发育障碍学龄儿童脑白质成熟的影响。
研究组纳入了芬兰于 1998 年 11 月至 2002 年 11 月在奥卢大学医院出生的 56 名极早产儿和 21 名足月产儿。早产儿的平均胎龄为 28.7（24.1-31.9）周。所有儿童在平均 9.0（8.6-9.6）岁时接受弥散张量成像检查。采用基于束的空间统计学方法对成像数据进行体素统计分析。
与足月产儿相比，有胎儿生长受限的早产儿双侧多个脑白质区域的各向异性分数降低，径向弥散度升高（p<0.05）。无胎儿生长受限的早产儿与足月产儿相比，在类似区域的平均弥散度和轴向弥散度升高（p<0.05），但更为不对称。
与足月产儿相比，在平均 9 岁时，早产儿的脑白质存在微观结构差异，而生长受限的早产儿与足月产儿相比，其脑白质成熟的广泛变化更为明显。胎儿生长和早产似乎以一种在该年龄仍可见的方式影响脑白质的成熟。
