OBJECTIVE: The Stockholm Neonatal Project involves a prospective,cross-sectional, population-based, cohort monitored for 12 to17 years after birth; it was started with the aim of investigatingthe long-term structural correlates of preterm birth and comparingfindings with reports on similar cohorts.
METHODS: High-resolution anatomic and diffusion tensor imagingdata measuring diffusion in 30 directions were collected byusing a 1.5-T MRI scanner. A total of 143 adolescents (12.18–17.7years of age) participated in the study, including 74 formerlypreterm infants with birth weights of 1500 g (range: 645–1486g) and 69 term control subjects. The 2 groups were well matchedwith respect to demographic and socioeconomic data. The anatomicMRI data were used for calculation of total brain volumes andvoxelwise comparison of gray matter (GM) volumes. The diffusiontensor imaging data were used for voxelwise comparison of whitematter (WM) microstructural integrity.
RESULTS: The formerly preterm individuals possessed 8.8% smallerGM volume and 9.4% smaller WM volume. The GM and WM volumesof individuals depended on gestational age and birth weight.The reduction in GM could be attributed bilaterally to the temporallobes, central, prefrontal, orbitofrontal, and parietal cortices,caudate nuclei, hippocampi, and thalami. Lower fractional anisotropywas observed in the posterior corpus callosum, fornix, and externalcapsules.
CONCLUSIONS: Although preterm birth was found to be a risk factorregarding long-term structural brain development, the outcomewas milder than in previous reports. This may be attributableto differences in social structure and neonatal care practices.
American Academy of Pediatrics , 2009. Vol. 124, no 5, e964-e972 p.
preterm, magnetic resonance imaging, brain, diffusion tensor imaging, follow-up evaluation