Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7009, Cincinnati, OH, 45229-3026, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Sci Rep. 2023 Sep 15;13(1):15273. doi: 10.1038/s41598-023-42281-0.
Growth in preterm infants in the neonatal intensive care unit (NICU) is associated with increased global and regional brain volumes at term, and increased postnatal linear growth is associated with higher language scores at age 2. It is unknown whether these relationships persist to school age or if an association between growth and cortical metrics exists. Using regression analyses, we investigated relationships between the growth of 42 children born extremely preterm (< 28 weeks gestation) from their NICU hospitalization, standardized neurodevelopmental/language assessments at 2 and 4-6 years, and multiple neuroimaging biomarkers obtained from T1-weighted images at 4-6 years. We found length at birth and 36 weeks post-menstrual age had positive associations with language scores at 2 years in multivariable linear regression. No growth metric correlated with 4-6 year assessments. Weight and head circumference at 36 weeks post-menstrual age positively correlated with total brain volume and negatively with global cortical thickness at 4-6 years of age. Head circumference relationships remained significant after adjusting for age, sex, and socioeconomic status. Right temporal cortical thickness was related to receptive language at 4-6 years in the multivariable model. Results suggest growth in the NICU may have lasting effects on brain development in extremely preterm children.
早产儿在新生儿重症监护病房（NICU）中的生长与足月时大脑整体和区域体积的增加有关，而出生后线性生长的增加与 2 岁时的语言评分较高有关。目前尚不清楚这些关系是否会持续到学龄期，或者生长与皮质指标之间是否存在关联。我们使用回归分析，研究了 42 名极早产儿（<28 周妊娠）从 NICU 住院到 2 岁和 4-6 岁时进行的标准化神经发育/语言评估，以及从 4-6 岁时 T1 加权图像获得的多个神经影像学生物标志物之间的生长关系。我们发现出生时的身长和孕龄 36 周与 2 岁时的语言评分在多变量线性回归中有正相关关系。没有生长指标与 4-6 岁的评估相关。孕龄 36 周时的体重和头围与大脑总容积呈正相关，与 4-6 岁时的大脑皮质总厚度呈负相关。在调整年龄、性别和社会经济地位后，头围的关系仍然显著。右颞叶皮质厚度与 4-6 岁时的接受性语言在多变量模型中相关。结果表明，NICU 中的生长可能对极早产儿的大脑发育产生持久影响。
