scholarly journals Individualized characterization of volumetric development in the preterm brain

2020 ◽  
Author(s):  
Ralica Dimitrova ◽  
Sophie Arulkumaran ◽  
Olivia Carney ◽  
Andrew Chew ◽  
Shona Falconer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Gestational Age ◽  
Significant Risk ◽  
Gaussian Process Regression ◽  
Large Degree ◽  
Magnetic Resonance Images ◽  
Single Individual ◽  
Equivalent Age

AbstractObjectivePreterm birth carries a significant risk for atypical development. While studies comparing group means have identified a number of early brain correlates of prematurity, they may ‘average out’ effects significant in a single individual. To understand better the cerebral consequences of prematurity, we created normative ‘growth curves’ characterizing neonatal brain development and explored the effect of preterm birth and related clinical risks in individual infants.MethodsWe used Gaussian process regression to map typical volumetric development in 275 healthy term-born infants, modelling for age at scan and sex. We compared magnetic resonance images of 89 preterm infants (born 28.7–34 weeks gestational age) scanned at term-equivalent age to these normative charts and related deviations from typical volumetric development to both perinatal clinical variables and neurocognitive scores at 18 months. We then tested if this approach can be generalized to an independent dataset of 253 preterm infants (born 28–31.6 weeks gestational age) also scanned at term-equivalent age but using different acquisition parameters and scanner, who were followed-up at 20 months.ResultsIn both preterm cohorts, cerebral atypicalities were widespread and often multiple, but varied highly between individual infants. Deviations from normative brain volumetric development were associated with perinatal factors including respiratory support, nutrition and postnatal growth, as well as with later neurocognitive outcome.ConclusionGroup-level understanding of the preterm brain might disguise a large degree of individual differences. We provide a method and a normative dataset for clinicians and researchers to profile the individual brain. This will allow a more precise characterization of the cerebral consequences of prematurity and improve the predictive power of neuroimaging.

scholarly journals Phenotyping the Preterm Brain: Characterizing Individual Deviations From Normative Volumetric Development in Two Large Infant Cohorts

2021 ◽  
Author(s):  
Ralica Dimitrova ◽  
Sophie Arulkumaran ◽  
Olivia Carney ◽  
Andrew Chew ◽  
Shona Falconer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Gaussian Process Regression ◽  
Large Degree ◽  
Brain Maturation ◽  
Independent Dataset ◽  
Normative Development ◽  
Equivalent Age ◽  
The Individual

Abstract The diverse cerebral consequences of preterm birth create significant challenges for understanding pathogenesis or predicting later outcome. Instead of focusing on describing effects common to the group, comparing individual infants against robust normative data offers a powerful alternative to study brain maturation. Here we used Gaussian process regression to create normative curves characterizing brain volumetric development in 274 term-born infants, modeling for age at scan and sex. We then compared 89 preterm infants scanned at term-equivalent age with these normative charts, relating individual deviations from typical volumetric development to perinatal risk factors and later neurocognitive scores. To test generalizability, we used a second independent dataset comprising of 253 preterm infants scanned using different acquisition parameters and scanner. We describe rapid, nonuniform brain growth during the neonatal period. In both preterm cohorts, cerebral atypicalities were widespread, often multiple, and varied highly between individuals. Deviations from normative development were associated with respiratory support, nutrition, birth weight, and later neurocognition, demonstrating their clinical relevance. Group-level understanding of the preterm brain disguises a large degree of individual differences. We provide a method and normative dataset that offer a more precise characterization of the cerebral consequences of preterm birth by profiling the individual neonatal brain.

scholarly journals Heterogeneity in Brain Microstructural Development Following Preterm Birth

2020 ◽  
Vol 30 (9) ◽  
pp. 4800-4810 ◽  
Author(s):  
Ralica Dimitrova ◽  
Maximilian Pietsch ◽  
Daan Christiaens ◽  
Judit Ciarrusta ◽  
Thomas Wolfers ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Mean Diffusivity ◽  
Gaussian Process Regression ◽  
Brain Regions ◽  
Cerebral Injury ◽  
Normative Values ◽  
Microstructural Development ◽  
Single Individual ◽  
Increased Risk

Abstract Preterm-born children are at increased risk of lifelong neurodevelopmental difficulties. Group-wise analyses of magnetic resonance imaging show many differences between preterm- and term-born infants but do not reliably predict neurocognitive prognosis for individual infants. This might be due to the unrecognized heterogeneity of cerebral injury within the preterm group. This study aimed to determine whether atypical brain microstructural development following preterm birth is significantly variable between infants. Using Gaussian process regression, a technique that allows a single-individual inference, we characterized typical variation of brain microstructure using maps of fractional anisotropy and mean diffusivity in a sample of 270 term-born neonates. Then, we compared 82 preterm infants to these normative values to identify brain regions with atypical microstructure and relate observed deviations to degree of prematurity and neurocognition at 18 months. Preterm infants showed strikingly heterogeneous deviations from typical development, with little spatial overlap between infants. Greater and more extensive deviations, captured by a whole brain atypicality index, were associated with more extreme prematurity and predicted poorer cognitive and language abilities at 18 months. Brain microstructural development after preterm birth is highly variable between individual infants. This poorly understood heterogeneity likely relates to both the etiology and prognosis of brain injury.

scholarly journals A birth population-based survey of preterm morbidity and mortality by gestational age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojing Guo ◽  
Xiaoqiong Li ◽  
Tingting Qi ◽  
Zhaojun Pan ◽  
Xiaoqin Zhu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Birth Defects ◽  
Gestational Age ◽  
Death Rate ◽  
Preterm Births ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Hospital Death

Abstract Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

scholarly journals Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 420
Author(s):  
Claudia Ioana Borțea ◽  
Florina Stoica ◽  
Marioara Boia ◽  
Emil Radu Iacob ◽  
Mihai Dinu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Surfactant Administration ◽  
Stage 1

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

scholarly journals Habituation as Parameter for Prediction of Mental Development in Healthy Preterm Infants

2016 ◽  
Vol 31 (14) ◽  
pp. 1591-1597 ◽  
Author(s):  
Peter Weber ◽  
Antoinette Depoorter ◽  
Patrick Hetzel ◽  
Sakari Lemola
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Mismatch Negativity ◽  
Infant Development ◽  
Mental Development ◽  
Learning Capability ◽  
Equivalent Age ◽  
Developmental Index ◽  
And Performance ◽  
Mental Developmental Index

The aim of this prospective pilot study was to evaluate the predictive value of discrimination and habituation, which was measured by mismatch negativity in 17 healthy very preterm (mean gestational age 27.4 weeks; range 25.0-31.3) and 16 term (mean gestational age 40.3 weeks; range 37.9-41.7) born infants at term equivalent age. Developmental outcome was measured by Bayley Scales of Infant Development–I in 13 preterm and 13 term-born children at a mean age of 21.7 months (±2.18) and 18.5 months (±1.9), respectively. No differences in amplitude and latency of the mismatch negativity were found between both groups at term equivalent age. Within the preterm group habituation capacity was positively correlated with the Mental Developmental Index ( r = .654, P = .008) and Performance Developmental Index ( r = .482, P = .048) at 21 months. Early learning capability, as measured by habituation, may be associated with a better prognosis for early mental development in healthy preterm infants.

Adiposity in small for gestational age preterm infants assessed at term equivalent age

2009 ◽  
Vol 94 (5) ◽  
pp. F368-F372 ◽  
Author(s):  
M L Gianni ◽  
P Roggero ◽  
F Taroni ◽  
N Liotto ◽  
P Piemontese ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Equivalent Age

scholarly journals Preterm birth alters the development of cortical microstructure and morphology at term-equivalent age

2021 ◽  
Author(s):  
Ralica Dimitrova ◽  
Maximilian Pietsch ◽  
Judit Ciarrusta ◽  
Sean P Fitzgibbon ◽  
Logan ZJ Williams ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Cortical Thickness ◽  
Tissue Water ◽  
Normative Development ◽  
Equivalent Age ◽  
Neurite Density ◽  
Postmenstrual Age ◽  
Cortical Maturation ◽  
Age At Birth

Introduction: The dynamic nature and complexity of the cellular events that take place during the last trimester of pregnancy make the developing cortex particularly vulnerable to perturbations. Abrupt interruption to normal gestation can lead to significant deviations to many of these processes, resulting in atypical trajectory of cortical maturation in preterm birth survivors. Methods: We sought to first map typical cortical micro and macrostructure development using invivo MRI in a large sample of healthy term-born infants scanned after birth (n=270). Then we offer a comprehensive characterisation of the cortical consequences of preterm birth in 78 preterm infants scanned at term-equivalent age (37-44 weeks postmenstrual age). We describe the group-average atypicality, the heterogeneity across individual preterm infants, and relate individual deviations from normative development to age at birth and neurodevelopment at 18 months. Results: In the term-born neonatal brain, we observed regionally specific age-associated changes in cortical morphology and microstructure, including rapid surface expansion, cortical thickness increase, reduction in cortical anisotropy and increase in neurite orientation dispersion. By term-equivalent age, preterm infants had on average increased cortical tissue water content and reduced neurite density index in the posterior parts of the cortex, and greater cortical thickness anteriorly compared to term-born infants. While individual preterm infants were more likely to show extreme deviations (over 3.1 standard deviations) from normative cortical maturation compared to term-born infants, these extreme deviations were highly variable and showed very little spatial overlap between individuals. Measures of regional cortical development were associated with age at birth, but not with neurodevelopment at 18 months. Conclusion: We showed that preterm birth alters cortical micro and macrostructural maturation near the time of full-term birth. Deviations from normative development were highly variable between individual preterm infants.

scholarly journals Galectin-Levels Are Elevated in Infants Born Preterm Due to Amniotic Infection and Rapidly Decline in the Neonatal Period

2021 ◽  
Vol 11 ◽  
Author(s):  
Kirstin Faust ◽  
Nancy Freitag ◽  
Gabriela Barrientos ◽  
Christoph Hartel ◽  
Sandra M. Blois
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Period ◽  
Venous Blood ◽  
Inverse Correlation ◽  
Complex Interactions ◽  
Maternal Immune System ◽  
Early Onset Sepsis ◽  
Inflammatory Milieu

Galectin (gal)-1, -3, and -9 are members of a family of glycan binding proteins that mediate complex interactions between decidual, inflammatory and trophoblast cells modulating several processes during gestation, control of the maternal immune system, and parturition. Their immunomodulatory role in preterm birth and postnatal expression in preterm infants is unknown. We performed a single center prospective study of 170 preterm infants with a gestational age below 35 weeks. Peripheral venous blood samples were collected during the neonatal period and galectin-1, -3, and -9 were determined by ELISA. We noted a strong decline of circulating gal-1 and -3 levels but not gal-9 from birth to day 7 of life. There was an inverse correlation of gal-1 and -3 levels at birth with gestational age. Gal-1 levels were remarkably increased in infants born to amniotic infection syndrome (AIS), which was also observed for gal-9 levels. Infants who developed early-onset sepsis had higher levels of gal-3 at day 1 as compared to unaffected infants. Our observational data imply that galectin-1, -3, and -9 levels are elevated in preterm infants born in an inflammatory milieu such as AIS or EOS. Future studies need to address whether galectins mediate inflammation-induced preterm birth and could therefore be a target for clinical trials.

Sign in / Sign up

Export Citation Format

Share Document