New research shows that preterm babies with slower brain development as they reach their due dates are more likely to have delayed cognitive, language, and motor development at 18 months of age. The researchers also found that preterm babies with significant injury to the brain’s white matter were more likely to have slower motor development as toddlers. Brain injuries in preterm babies are most often linked to lack of brain blood flow or to inflammation.
“These data suggest that babies born preterm have the potential to do just as well as infants born full-term,” says Dr. Anne Synnes, a co-author with the study. Dr. Synnes is a clinical investigator at the Child & Family Research Institute (CFRI), a neonatologist at BC Women’s Hospital, and a clinical associate professor in the Division of Neonatology in the Department of Pediatrics at the University of British Columbia (UBC). “This opens the window to learn more about how to improve the day to day care of these babies to support their optimal brain development.”
The research is published in the December 10, 2013 issue of Neurology®, the medical journal of the American Academy of Neurology.
“Our findings point to preterm infant brain health as a dynamic process that evolves over the weeks of neonatal intensive care,” says Dr. Steven Miller, the study’s principal investigator. Dr. Miller was a neurologist at BC Children’s Hospital and a CFRI clinician scientist at the time the newborns were studied. He is currently the head of Neurology at SickKids, professor of Paediatrics at the University of Toronto, the Bloorview Children’s Hospital Chair in Paediatric Neuroscience, and a UBC affiliate professor of Pediatrics. “Earlier studies by our group and others have identified common conditions such as postnatal infection, lung disease, and pain as potential risk factors that could be addressed to support healthier brain development in preterm babies,” he says.
“Because brain development is a dynamic process that evolves over time, these findings mean there is an opportunity to improve infant brain health,” says Dr. Vann Chau, the study’s first author, a neurologist at SickKids and CFRI clinical investigator. “This view is different from the previous assumption that once the injury is done, it is too late.”
The study involved 154 preterm babies born after 24-32 weeks of pregnancy and cared for at BC Women’s Hospital & Health Centre in Vancouver between April 2006 and August 2010. The babies had an MRI (magnetic resonance imaging) scan once they were clinically stable within the first few weeks of life, and then again at what would have been their due dates. Researchers at the adjoining BC Children’s looked at how the babies’ brain microstructure and metabolism had matured over that time period. The researchers then assessed the children’s cognition, language and motor skills at 18 months of age.
The study is co-led by Dr. Ruth Grunau, CFRI senior scientist and professor, Division of Neonatology, UBC Department of Pediatrics. The research team also includes Dr. Kenneth Poskitt and Dr. Rollin Brant of CFRI, BC Children’s and UBC. This study is funded by the Canadian Institutes of Health Research, the Michael Smith Foundation for Health Research, the Canada Research Chairs Program, CFRI, and BC Children’s Hospital Foundation.