Background and aims Cerebral MRI is increasingly used to depict the wide spectrum of preterm brain injury. Furthermore MRI also illustrates postnatal brain development in preterm infants. It has been shown by MRI at term-equivalent age (TEA) that preterm infants show a delayed brain maturation as compared to term infants and this delay has been related to neurobehavioral outcome. The aim of the present study was to investigate the influence of prevalent neonatal morbidities on structural cerebral brain maturation in a cohort of preterm infants born at a GA ≤32 completed weeks.
Methods 130 very preterm infants born at a mean gestational age of 29.7 ± 2.1 weeks and a mean birthweight of 1265 ± 405 grams were included. Brain MRI was performed at a mean postmenstrual age of 40.7 weeks (range 39–43). Structural brain development was evaluated by a validated “total maturation score”. Brain maturation was correlated to neonatal data.
Results In univariate analysis bronchopulmonary dysplasia (BPD) and late-onset sepsis were significantly associated with delayed brain maturation. In multivariate analysis BPD remained significant for delayed maturation, with the diagnosis BPD carrying a fourfold risk for delay.
Conclusions This study is the first to show that delayed structural brain maturation in preterm infants at TEA is preceded by BPD, which is a known predictor of adverse outcome. This finding adds further evidence that the neural correlates of adverse outcome go beyond mere brain “injury”.
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