Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
Hum Brain Mapp. 2022 Apr 1;43(5):1577-1589. doi: 10.1002/hbm.25743. Epub 2021 Dec 12.
Infants born in early term (37-38 weeks gestation) experience slower neurodevelopment than those born at full term (40-41 weeks gestation). While this could be due to higher perinatal morbidity, gestational age at birth may also have a direct effect on the brain. Here we characterise brain volume and white matter correlates of gestational age at birth in healthy term-born neonates and their relationship to later neurodevelopmental outcome using T2 and diffusion weighted MRI acquired in the neonatal period from a cohort (n = 454) of healthy babies born at term age (>37 weeks gestation) and scanned between 1 and 41 days after birth. Images were analysed using tensor-based morphometry and tract-based spatial statistics. Neurodevelopment was assessed at age 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants born earlier had higher relative ventricular volume and lower relative brain volume in the deep grey matter, cerebellum and brainstem. Earlier birth was also associated with lower fractional anisotropy, higher mean, axial, and radial diffusivity in major white matter tracts. Gestational age at birth was positively associated with all Bayley-III subscales at age 18 months. Regression models predicting outcome from gestational age at birth were significantly improved after adding neuroimaging features associated with gestational age at birth. This work adds to the body of evidence of the impact of early term birth and highlights the importance of considering the effect of gestational age at birth in future neuroimaging studies including term-born babies.
早产儿(37-38 周)的神经发育速度比足月儿(40-41 周)慢。虽然这可能是由于围产期发病率较高,但出生时的胎龄也可能对大脑有直接影响。在这里,我们使用在新生儿期采集的 T2 和弥散加权 MRI 来描述健康足月新生儿出生时胎龄的脑容量和白质相关性,并研究其与神经发育结果的关系。该队列(n=454)包括在足月(>37 周)时出生并在出生后 1 至 41 天内接受扫描的健康婴儿。使用基于张量的形态计量学和基于束的空间统计学来分析图像。使用 Bayley 婴幼儿发育量表第三版(Bayley-III)在 18 个月龄时评估神经发育。出生较早的婴儿在深灰质、小脑和脑干中有更高的相对脑室容积和更低的相对脑容量。出生较早还与主要白质束中较低的各向异性分数、较高的平均弥散、轴向弥散和径向弥散有关。出生时的胎龄与 18 个月时的所有 Bayley-III 子量表呈正相关。在添加与出生时胎龄相关的神经影像学特征后,用于预测结局的胎龄回归模型得到了显著改善。这项工作增加了早期足月分娩影响的证据,并强调了在未来包括足月出生婴儿在内的神经影像学研究中考虑出生时胎龄影响的重要性。