Peter J Anderson1, Karli Treyvaud2, Jeffrey J Neil3, Jeanie L Y Cheong4, Rodney W Hunt5, Deanne K Thompson6, Katherine J Lee6, Lex W Doyle7, Terrie E Inder8. 1. Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. Electronic address: peter.j.anderson@monash.edu. 2. Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Psychology and Counseling, La Trobe University, Melbourne, Victoria, Australia. 3. Department of Neurology, Boston Children's Hospital, Boston, MA; Harvard Medical School, Harvard University, Boston, MA. 4. Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Victoria, Australia; Newborn Intensive Care, The Royal Women's Hospital, Melbourne, Victoria, Australia. 5. Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Neonatal Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia. 6. Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia. 7. Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Victoria, Australia; Newborn Intensive Care, The Royal Women's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Victoria, Australia. 8. Harvard Medical School, Harvard University, Boston, MA; Pediatric Newborn Medicine, The Brigham and Women's Hospital, Boston, MA.
Abstract
OBJECTIVE: To determine the relationship between brain abnormalities on newborn magnetic resonance imaging (MRI) and neurodevelopmental impairment at 7 years of age in very preterm children. STUDY DESIGN: A total of 223 very preterm infants (<30 weeks of gestation or <1250 g) born at Melbourne's Royal Women's Hospital had a brain MRI scan at term equivalent age. Scans were scored using a standardized system that assessed structural abnormality of cerebral white matter, cortical gray matter, deep gray matter, and cerebellum. Children were assessed at 7 years on measures of general intelligence, motor functioning, academic achievement, and behavior. RESULTS: One hundred eighty-six very preterm children (83%) had both an MRI at term equivalent age and a 7-year follow-up assessment. Higher global brain, cerebral white matter, and deep gray matter abnormality scores were related to poorer intelligence quotient (IQ) (Ps < .01), spelling (Ps < .05), math computation (Ps < .01), and motor function (Ps < .001). Higher cerebellum abnormality scores were related to poorer IQ (P = .001), math computation (P = .018), and motor outcomes (P = .001). Perinatal, neonatal, and social confounders had little effect on the relationships between the MRI abnormality scores and outcomes. Moderate-severe global abnormality on newborn MRI was associated with a reduction in IQ (-6.9 points), math computation (-7.1 points), and motor (-1.9 points) scores independent of the other potential confounders. CONCLUSIONS: Structured evaluation of brain MRI at term equivalent is predictive of outcome at 7 years of age, independent of clinical and social factors.
OBJECTIVE: To determine the relationship between brain abnormalities on newborn magnetic resonance imaging (MRI) and neurodevelopmental impairment at 7 years of age in very preterm children. STUDY DESIGN: A total of 223 very preterm infants (<30 weeks of gestation or <1250 g) born at Melbourne's Royal Women's Hospital had a brain MRI scan at term equivalent age. Scans were scored using a standardized system that assessed structural abnormality of cerebral white matter, cortical gray matter, deep gray matter, and cerebellum. Children were assessed at 7 years on measures of general intelligence, motor functioning, academic achievement, and behavior. RESULTS: One hundred eighty-six very preterm children (83%) had both an MRI at term equivalent age and a 7-year follow-up assessment. Higher global brain, cerebral white matter, and deep gray matter abnormality scores were related to poorer intelligence quotient (IQ) (Ps < .01), spelling (Ps < .05), math computation (Ps < .01), and motor function (Ps < .001). Higher cerebellum abnormality scores were related to poorer IQ (P = .001), math computation (P = .018), and motor outcomes (P = .001). Perinatal, neonatal, and social confounders had little effect on the relationships between the MRI abnormality scores and outcomes. Moderate-severe global abnormality on newborn MRI was associated with a reduction in IQ (-6.9 points), math computation (-7.1 points), and motor (-1.9 points) scores independent of the other potential confounders. CONCLUSIONS: Structured evaluation of brain MRI at term equivalent is predictive of outcome at 7 years of age, independent of clinical and social factors.
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