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Am J Perinatol 2015; 32(12): 1177-1184
DOI: 10.1055/s-0035-1552936
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Regional Brain Biometrics at Term-Equivalent Age and Developmental Outcome in Extremely Low-Birth-Weight Infants

Launice Melbourne
1   Divsion of Neonatology, Children's National Health Systems, Washington, District of Columbia
2   Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
,
Jonathan Murnick
2   Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
3   Divsion of Diagnostic Imaging and Radiology, Children's National Health Systems, Washington, District of Columbia
,
Taeun Chang
2   Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
4   Department of Neurology, Children's National Health Systems, Washington, District of Columbia
,
Penny Glass
2   Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
5   Divsion of Psychology and Behavioral Health, Children's National Health Systems, Washington, District of Columbia
,
An N. Massaro
1   Divsion of Neonatology, Children's National Health Systems, Washington, District of Columbia
2   Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
› Author Affiliations
Further Information

Publication History

15 December 2014

01 April 2015

Publication Date:
22 May 2015 (online)

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Abstract

Objective This study aims to evaluate individual regional brain biometrics and their association with developmental outcome in extremely low-birth-weight (ELBW) infants.

Study Design This is a retrospective study evaluating term-equivalent magnetic resonance imaging (TE-MRI) from 27 ELBW infants with known developmental outcomes beyond 12 months corrected age. Regional biometric measurements were performed by a pediatric neuroradiologist blinded to outcome data. Measures included biparietal width, transcerebellar diameter (TCD), deep gray matter area (DGMA), ventricular dilatation, corpus callosum, and interhemispheric distance. The relationship between regional biometrics and Bayley-II developmental scores were evaluated with linear regression models.

Results The study cohort had an average ± standard deviation birth weight of 684 ± 150 g, gestational age of 24.6 ± 2 weeks and 48% males. DGMA was significantly associated with both cognitive and motor outcomes. Significant associations were also observed between TCD and corpus callosum splenium with cognitive and motor outcomes, respectively. Other biometric measures were not associated with outcome (p > 0.05). DGMA < 10.26 cm2 was highly specific for poor motor and cognitive outcome.

Conclusion TE-MRI biometrics reflecting impaired deep gray matter, callosal, and cerebellar size is associated with worse early childhood cognitive and motor outcomes. DGMA may be the most robust single biometric measure to predict adverse developmental outcome in preterm survivors.

Keywords

magnetic resonance imaging - brain - extremely low-birth-weight infant - neurodevelopmental outcome - prematurity