Torin J A Glass1, Vann Chau2, Ruth E Grunau3, Anne Synnes3, Ting Guo1, Emma G Duerden1, Justin Foong4, Kenneth J Poskitt5, Steven P Miller6. 1. Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health, SickKids Research Institute, Toronto, Ontario, Canada. 2. Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada. 3. BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Department of Pediatrics (Neonatology), University of British Columbia and BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada. 4. Neurosciences & Mental Health, SickKids Research Institute, Toronto, Ontario, Canada. 5. Department of Radiology, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada. 6. Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Ontario, Canada; Neurosciences & Mental Health, SickKids Research Institute, Toronto, Ontario, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada. Electronic address: steven.miller@sickkids.ca.
Abstract
OBJECTIVES: To evaluate whether the number of postnatal infections is associated with abnormal white matter maturation and poorer motor neurodevelopmental outcomes at 36 months of corrected age. STUDY DESIGN: A prospective longitudinal cohort study was undertaken of 219 newborns born preterm at 24-32 weeks of gestational age recruited between 2006 and 2013 with magnetic resonance imaging of the brain both early in life and at term-equivalent age. Postnatal infection was defined as any clinical infection or positive culture ≥72 hours after birth. White matter maturation was assessed by magnetic resonance spectroscopic imaging, magnetic resonance diffusion tensor imaging, and tract-based spatial statistics. Neurodevelopmental outcomes were assessed in 175 (82% of survivors) infants with Bayley Scales of Infant and Toddler Development-III composite scores and Peabody Developmental Motor Scales at 35 months of corrected age (IQR 34-37 months). Infection groups were compared via the Fisher exact test, Kruskal-Wallis test, and generalized estimating equations. RESULTS: Of 219 neonates born preterm (median gestational age 27.9 weeks), 109 (50%) had no postnatal infection, 83 (38%) had 1 or 2 infections, and 27 (12%) had ≥3 infections. Infants with postnatal infections had more cerebellar hemorrhage. Infants with ≥3 infections had lower N-acetylaspartate/choline in the white matter and basal ganglia regions, lower fractional anisotropy in the posterior limb of the internal capsule, and poorer maturation of the corpus callosum, optic radiations, and posterior limb of the internal capsule on tract-based spatial statistics analysis as well as poorer Bayley Scales of Infant and Toddler Development-III (P = .02) and Peabody Developmental Motor Scales, Second Edition, motor scores (P < .01). CONCLUSIONS: In newborns born preterm, ≥3 postnatal infections predict impaired development of the motor pathways and poorer motor outcomes in early childhood.
OBJECTIVES: To evaluate whether the number of postnatal infections is associated with abnormal white matter maturation and poorer motor neurodevelopmental outcomes at 36 months of corrected age. STUDY DESIGN: A prospective longitudinal cohort study was undertaken of 219 newborns born preterm at 24-32 weeks of gestational age recruited between 2006 and 2013 with magnetic resonance imaging of the brain both early in life and at term-equivalent age. Postnatal infection was defined as any clinical infection or positive culture ≥72 hours after birth. White matter maturation was assessed by magnetic resonance spectroscopic imaging, magnetic resonance diffusion tensor imaging, and tract-based spatial statistics. Neurodevelopmental outcomes were assessed in 175 (82% of survivors) infants with Bayley Scales of Infant and Toddler Development-III composite scores and Peabody Developmental Motor Scales at 35 months of corrected age (IQR 34-37 months). Infection groups were compared via the Fisher exact test, Kruskal-Wallis test, and generalized estimating equations. RESULTS: Of 219 neonates born preterm (median gestational age 27.9 weeks), 109 (50%) had no postnatal infection, 83 (38%) had 1 or 2 infections, and 27 (12%) had ≥3 infections. Infants with postnatal infections had more cerebellar hemorrhage. Infants with ≥3 infections had lower N-acetylaspartate/choline in the white matter and basal ganglia regions, lower fractional anisotropy in the posterior limb of the internal capsule, and poorer maturation of the corpus callosum, optic radiations, and posterior limb of the internal capsule on tract-based spatial statistics analysis as well as poorer Bayley Scales of Infant and Toddler Development-III (P = .02) and Peabody Developmental Motor Scales, Second Edition, motor scores (P < .01). CONCLUSIONS: In newborns born preterm, ≥3 postnatal infections predict impaired development of the motor pathways and poorer motor outcomes in early childhood.
Authors: M N Parikh; M Chen; A Braimah; J Kline; K McNally; J W Logan; L Tamm; K O Yeates; W Yuan; L He; N A Parikh Journal: AJNR Am J Neuroradiol Date: 2021-05-06 Impact factor: 4.966
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Authors: Sagori Mukhopadhyay; Karen M Puopolo; Nellie I Hansen; Scott A Lorch; Sara B DeMauro; Rachel G Greenberg; C Michael Cotten; Pablo J Sanchez; Edward F Bell; Eric C Eichenwald; Barbara J Stoll Journal: Arch Dis Child Fetal Neonatal Ed Date: 2021-01-21 Impact factor: 6.643