Original ArticleExtreme Premature Birth is not Associated with Impaired Development of Brain Microstructure
Section snippets
Methods
The study population includes infants born between 24 and 33 weeks gestation, admitted to the intensive care nurseries at University of California, San Francisco (UCSF) and the Children's & Women's Health Center of British Columbia (UBC). Exclusion criteria included evidence of congenital infections, malformations or chromosomal anomalies, and ultrasound scanning evidence of large (>2 cm) parenchymal hemorrhagic infarction. The study subjects underwent imaging twice according to study protocol,
Results
Serial diffusion tensor imaging data were available for a total of 176 infants, 97 enrolled between April 2001 and March 2008 at UCSF and 79 enrolled from April 2006 to December 2008 at UBC. During the study period, at UCSF there were an additional 54 infants enrolled who either underwent only 1 scan (36 infants) or the diffusion tensor imaging data were motion degraded (18 infants) and they were not included in this analysis. At UBC, there were an additional 27 infants enrolled who did not
Discussion
The effect of gestational age at birth on developing white and gray matter microstructure can be assessed with diffusion parameter (fractional anisotropy or mean diffusivity) changes with time, and we were unable to demonstrate an effect. Extremely premature birth, at <26 weeks, had a detrimental effect on the change in white matter fractional anisotropy. However, this effect was eliminated by neonatal morbidities that commonly accompany extreme premature birth, such as the presence of a PDA,
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