Objective To explore whether regional brain volume and white matter microstructure at term-equivalent age (TEA) are associated with development at 2 years of age in children born moderate–late preterm (MLPT).
Study design A cohort of MLPT infants had brain MRI at approximately TEA (38–44 weeks’ postmenstrual age) and had a developmental assessment (Bayley Scales of Infant and Toddler Development and Infant Toddler Social Emotional Assessment) at 2 years’ corrected age. Relationships between cortical grey matter and white matter volumes and 2-year developmental outcomes were explored using voxel-based morphometry. Relationships between diffusion tensor measures of white matter microstructure (fractional anisotropy (FA) and axial (AD), radial (RD) and mean (MD) diffusivities) and 2-year developmental outcomes were explored using tract-based spatial statistics.
Results 189 MLPT children had data from at least one MRI modality (volumetric or diffusion) and data for at least one developmental domain. Larger cortical grey and white matter volumes in many brain regions, and higher FA and lower AD, RD and MD in several major white matter regions, were associated with better cognitive and language scores. There was little evidence that cortical grey matter and white matter volumes and white matter microstructure were associated with motor and behavioural outcomes.
Conclusions Regional cortical grey matter and white matter volumes and white matter microstructure are associated with cognitive and language development at 2 years of age in MLPT children. Thus, early alterations to brain volumes and microstructure may contribute to some of the developmental deficits described in MLPT children.
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Contributors JLYC, AS, LWD, PA, DT and MS were involved in the conception and design of the study, and the acquisition of the MRI data and clinical data. CEK, JC and DT were involved in the processing of the MRI images. CK performed the statistical analyses and drafted the manuscript. JLYC, AS, LWD, PA, DT, MS, JC and CK revised the manuscript critically for important intellectual content, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Funding This work was supported in part by the Australian National Health and Medical Research Council (NHMRC) (Project Grant ID 1028822 and 1024516; Centre of Clinical Research Excellence Grant ID 546519; Centre of Research Excellence Grant ID 1060733; Senior Research Fellowship ID 1081288 to PA; Early Career Fellowship ID 1053787 to JLYC, ID 1053767 to AS, ID 1012236 to DT; Career Development Fellowship ID 1141354 to JLYC, ID 1108714 to AS, ID 1085754 to DT), Murdoch Children’s Research Institute Clinical Sciences Theme Grant, the Royal Children’s Hospital, the Department of Paediatrics at the University of Melbourne, the Victorian Government Operational Infrastructure Support Program, and The Royal Children’s Hospital Foundation.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Human Research Ethics Committee of the Royal Women’s Hospital, Melbourne (approval number Project 09/38).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available from the corresponding author upon reasonable request.