Elsevier

The Journal of Pediatrics

Volume 155, Issue 6, December 2009, Pages 848-853.e1
The Journal of Pediatrics

Original Article
Segmental Brain Volumes and Cognitive and Perceptual Correlates in 15-Year-Old Adolescents with Low Birth Weight

https://doi.org/10.1016/j.jpeds.2009.06.015Get rights and content

Objective

To determine whether preterm very low birth weight (VLBW) or term born small for gestational age (SGA) adolescents have reduced regional brain volumes. We also asked which perinatal factors are related to reduced brain volume in VLBW adolescents, which regional brain volumes are associated with cognitive and perceptual functioning, and if these differ between the groups.

Study design

Fifty adolescent preterm VLBW (≤1500 g) births and 49 term SGA births (birth weight <10th percentile) were compared with 57 normal-weight term births. An automated MRI segmentation technique was used. Cognitive and perceptual functions were evaluated by WISC-III and Visual Motor Integration (VMI) tests.

Results

The VLBW group had reduced volumes for thalamus and cerebellar white matter (P < .002). The SGA group had smaller total brains, and proportionally smaller regional brain volumes. Cerebellar white matter in the VLBW, hippocampus in the SGA, and cerebral cortical in the control group were volumes that significantly predicted cognitive and perceptual functions.

Conclusions

We speculate that white matter injury may explain the impaired cognitive and perceptual functioning in the prematurely born, whereas hippocampal injury may be related to cognitive dysfunction in term SGA adolescents.

Section snippets

Methods

In a follow-up study of 15-year-old children, we examined 2 groups with low birth weights, that is, prematurely born infants with very low birth weight (VLBW) and term SGA births. These groups were compared with a group of term normal-weight births. The VLBW children were admitted to the neonatal intensive care unit at the University Hospital in Trondheim (the referral hospital) from 1986 to 1988. The SGA and control group children were the second or third births to mothers living in the

Results

The VLBW subjects had significantly lower gestational age than the control subjects (Table I). Birth weight, Z score of birth weight, and head circumference were significantly reduced in the VLBW and SGA groups. The VLBW adolescents were approximately 4 to 5 months younger than the control adolescents when they were scanned.

The brain volume of the 3 study groups are presented in Table II (available at www.jpeds.com). The differences in brain structures were explored in relation to the total

Discussion

We found that low birth weight was associated with reduced brain volume in adolescents. Whereas prematurity was associated with a reduction in specific brain regions, term low birth weight was associated with a lower scaling of the brain. The age at scan was an important determining factor in regional brain volume, and our findings, which showed a decrease in cortical gray matter and an increase in white matter volume by age, are consistent with other reports.18 The most common brain

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    Funding information available at www.jpeds.com (Appendix). A.M.D. and B.F. are funded by CorTechs Labs, Inc. A.M.D. has equity in CorTechs Labs, Inc. The other authors declare no conflicts of interest.

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