Extreme Premature Birth is not Associated with Impaired Development of Brain Microstructure

被引:76
作者
Bonifacio, Sonia L. [1 ]
Glass, Hannah C. [2 ]
Chau, Vann [4 ]
Berman, Jeffrey I. [3 ]
Xu, Duan [3 ]
Brant, Rollin [5 ]
Barkovich, A. James [2 ,3 ]
Poskitt, Kenneth J. [6 ]
Miller, Steven P. [2 ,4 ]
Ferriero, Donna M. [2 ]
机构
[1] Univ Calif San Francisco, Sch Med, Dept Pediat, Div Neonatol, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA
[4] Univ British Columbia, Dept Pediat, Vancouver, BC V6T 1W5, Canada
[5] Univ British Columbia, Dept Biostat, Vancouver, BC V5Z 1M9, Canada
[6] Univ British Columbia, Dept Radiol, Vancouver, BC, Canada
关键词
WHITE-MATTER DEVELOPMENT; EXTREMELY PRETERM BIRTH; DIFFUSION TENSOR MRI; TERM-EQUIVALENT AGE; PERIVENTRICULAR LEUKOMALACIA; INTENSIVE-CARE; INFANTS; INJURY; NEWBORNS; ABNORMALITIES;
D O I
10.1016/j.jpeds.2010.05.026
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To assess whether birth at <26 weeks gestation is an important predictor of brain microstructure maturation as determined by using diffusion tensor imaging. Study design We performed serial magnetic resonance imaging and diffusion tensor imaging in 176 infants born at <33 weeks gestation. Diffusion parameters were calculated for white and gray matter regions. Linear regression for repeated measures was used to assess the effect of extremely premature birth on brain maturation. Results In white matter, fractional anisotropy increased by 0.008 per week (95% CI, 0.007-0.009; P <. 0001) and mean diffusivity decreased by 0.021 mm(2)/sec per week, (95% CI, -0.24-0.018; P <. 0001). Birth at < 26 weeks was associated with lower white matter fractional anisotropy (-0.01; 95% CI, -0.018-0.003; P = .008), but this effect was eliminated when co-morbid conditions were added to the model. Moderate-severe brain injury was associated with decreased mean white matter fractional anisotropy (-0.012; 95% CI, -0.02-0.004; P = .002). Conclusion Brain microstructure maturation as measured serially in premature infants is independent of extremely premature birth. Brain injury and co-morbid conditions may be the important determinants of microstructure maturation. (J Pediatr 2010; 157:726-32).
引用
收藏
页码:726 / U55
页数:8
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