Shannon E Scratch1, Peter J Anderson1, Lex W Doyle1, Deanne K Thompson1, Zohra M Ahmadzai1, Ronda F Greaves1, Terrie E Inder1, Rodney W Hunt1. 1. Clinical Sciences (S.E.S., P.J.A., L.W.D., D.K.T., Z.M.A., R.F.G., T.E.I., R.W.H.), Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, 3052 Australia; Faculty of Medicine, Dentistry and Health Sciences (S.E.S., P.J.A., L.W.D., D.K.T., R.W.H.), The University of Melbourne, Victoria, 3010 Australia; The Royal Women's Hospital (L.W.D.), Victoria, 3052 Australia; School of Medical Sciences (R.F.G.), RMIT University, Victoria, 3000 Australia; Department of Pediatric Newborn Medicine (T.E.I.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; and The Royal Children's Hospital (R.W.H.), Melbourne, 3052 Australia.
Abstract
CONTEXT AND OBJECTIVES: Little is known regarding the influence of GH on brain development, especially in infants born very preterm (VP; <30 weeks' gestation). Preterm infants are thought to have higher levels of GH in the first days of life compared with full-term infants. VP infants experience cognitive difficulties in childhood and have a diffuse pattern of structural brain abnormalities. This study aimed to explore the relationship between postnatal GH concentrations following VP birth and its association with cognitive functioning and brain volumes at age 7 years. METHODS: Eighty-three infants born VP had GH concentrations measured at eight time points postnatally, and 2- and 6-week area under the curve (AUC) summary measures were calculated. Followup at age 7 years included neuropsychological assessment and brain magnetic resonance imaging. Univariable and multivariable regression modeling were used where AUC for GH was the main predictor of neurodevelopmental outcome at age 7 years. RESULTS: Univariable modeling revealed that higher GH levels (2-week AUC) were related to poorer performance on a verbal working memory (P = .04) and shifting attention task (P = .01). These relationships persisted on multivariable modeling and when the 6-week AUC was analyzed; working memory (P = .03), immediate spatial memory (P = .02), and delayed spatial memory (P = .03) deficits were found. Higher GH levels were also associated with larger amygdala volumes after adjustment for potential confounders (P = .002, 2-week AUC; P = .03, 6-week AUC). CONCLUSIONS: Higher postnatal GH levels may potentially contribute to the documented neurodevelopmental abnormalities seen in children born VP at school age.
CONTEXT AND OBJECTIVES: Little is known regarding the influence of GH on brain development, especially in infants born very preterm (VP; <30 weeks' gestation). Preterm infants are thought to have higher levels of GH in the first days of life compared with full-term infants. VP infants experience cognitive difficulties in childhood and have a diffuse pattern of structural brain abnormalities. This study aimed to explore the relationship between postnatal GH concentrations following VP birth and its association with cognitive functioning and brain volumes at age 7 years. METHODS: Eighty-three infants born VP had GH concentrations measured at eight time points postnatally, and 2- and 6-week area under the curve (AUC) summary measures were calculated. Followup at age 7 years included neuropsychological assessment and brain magnetic resonance imaging. Univariable and multivariable regression modeling were used where AUC for GH was the main predictor of neurodevelopmental outcome at age 7 years. RESULTS: Univariable modeling revealed that higher GH levels (2-week AUC) were related to poorer performance on a verbal working memory (P = .04) and shifting attention task (P = .01). These relationships persisted on multivariable modeling and when the 6-week AUC was analyzed; working memory (P = .03), immediate spatial memory (P = .02), and delayed spatial memory (P = .03) deficits were found. Higher GH levels were also associated with larger amygdala volumes after adjustment for potential confounders (P = .002, 2-week AUC; P = .03, 6-week AUC). CONCLUSIONS: Higher postnatal GH levels may potentially contribute to the documented neurodevelopmental abnormalities seen in children born VP at school age.
Authors: P Sytze van Dam; Channa F de Winter; Rehana de Vries; Jeroen van der Grond; Madeleine L Drent; Marijn Lijffijt; J Leon Kenemans; André Aleman; Edward H F de Haan; Hans P F Koppeschaar Journal: Psychoneuroendocrinology Date: 2005-01-12 Impact factor: 4.905