Severity of Germinal Matrix-Intraventricular Hemorrhage Impacts Thalamic Growth and Neurodevelopmental Outcomes in Preterm Infants: A Longitudinal Magnetic Resonance Study.

BACKGROUND

Preterm birth and germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) can significantly affect neurodevelopment in very-low-birth-weight infants (VLBWI). This study examined the impact of GMH-IVH on thalamic volume (TV) during the neonatal period and its relationship with cognitive, motor, and language outcomes at two years corrected age.

METHODS

Preterm infants admitted to the neonatal intensive care unit at Hospital Puerta del Mar underwent early (<36 weeks postmenstrual age) and term-equivalent magnetic resonance imaging to assess thalamic growth. Neurodevelopmental outcomes were evaluated using the Bayley Scales of Infant and Toddler Development.

RESULTS

The severity of GMH-IVH correlated with greater reductions in TV. At term, infants without GMH-IVH had a mean TV of 3.72 ± 0.65 cm, compared with 2.76 ± 0.55 cm in those with grade III GMH-IVH (P = 0.0001). Grade III GMH-IVH and parenchymal hemorrhagic infarction were linked to significantly lower cognitive (P = 0.024), language (P = 0.001), and motor scores (P = 0.006) at two years, with reduced TV contributing to poorer language outcomes (β = 9.857; P = 0.028). Our findings suggest that GMH-IVH negatively affects thalamic growth, which in turn leads to neurodevelopmental delays in preterm infants.

CONCLUSIONS

The severity of GMH-IVH is associated with decreased TV and adverse cognitive, language, and motor outcomes, highlighting the need for early identification and targeted interventions in this vulnerable population. Further research should explore additional brain structures affected by GMH-IVH to better understand the mechanisms driving these impairments.