Key Points Question Is prenatal exposure to maternal social disadvantage and psychosocial stress associated with global and relative infant brain volumes at birth? Findings In this longitudinal, observational cohort study of 280 mother-infant dyads, prenatal exposure to greater maternal social disadvantage, but not psychosocial stress, was associated with statistically significant reductions in white matter, cortical gray matter, and subcortical gray matter volumes and cortical folding at birth after accounting for maternal health and diet. Meaning These findings suggest that prenatal exposure to social disadvantage is associated with global reductions in brain volumes and folding in the first weeks of life.

Preterm infants are at high risk for brain injury during the perinatal period. Intraventricular hemorrhage and periventricular leukomalacia, the two most common patterns of brain injury in prematurely-born children, are associated with poor neurodevelopmental outcomes. The hippocampus is known to be critical for learning and memory; however, it remains unknown how these forms of brain injury affect hippocampal growth and how the resulting alterations in hippocampal development relate to childhood outcomes. To investigate these relationships, hippocampal segmentations were performed on term equivalent MRI scans from 55 full-term infants, 85 very preterm infants (born ≤32 weeks gestation) with no to mild brain injury and 73 very preterm infants with brain injury ( e.g. , grade III/IV intraventricular hemorrhage, post-hemorrhagic hydrocephalus, cystic periventricular leukomalacia). Infants then underwent standardized neurodevelopmental testing using the Bayley Scales of Infant and Toddler Development, 3rd edition at age 2 years, corrected for prematurity. To delineate the effects of brain injury on early hippocampal development, hippocampal volumes were compared across groups and associations between neonatal volumes and neurodevelopmental outcomes at age 2 years were explored. Very preterm infants with brain injury had smaller hippocampal volumes at term equivalent age compared to term and very preterm infants with no to mild injury, with the smallest hippocampi among those with grade III/IV intraventricular hemorrhage and post-hemorrhagic hydrocephalus. Further, larger ventricle size was associated with smaller hippocampal size. Smaller hippocampal volumes were related to worse motor performance at age 2 years across all groups. In addition, smaller hippocampal volumes in infants with brain injury were correlated with impaired cognitive scores at age 2 years, a relationship specific to this group. Consistent with our preclinical findings, these findings demonstrate that perinatal brain injury is associated with hippocampal size in preterm infants, with smaller volumes related to domain-specific neurodevelopmental impairments in this high-risk clinical population.

ImportanceHow maternal experiences of adversity/advantage during pregnancy impact the developing fetus remains unclear.ObjectiveUsing prospective data about experiences of adversity/advantage and other factors known to impact fetal developmental, we explored how these risk and protective factors relate to each other and impact infant birth weight by gestational age.DesignA prospective study that collected data on of forms of social advantage/disadvantage, and psychological factors from pregnant women during each trimester of pregnancy that accounted for maternal medical and nutritional status. We aimed to determine the differential impact of social advantage/disadvantage and adversity and psychological factors on infant birthweight accounting for gestational age. Structural Equation Modeling (SEM) was used to investigate the relationship of these forms of adversity as latent constructs on infant outcome. The follow-up of children is ongoing as a part of the Early Life Adversity Biological Embedding and Risk for Developmental Precursors of Mental Disorders (eLABE). Data collection was conducted from 2017-2020.SettingAn academic medical center.ParticipantsPregnant women who were participants in a study of preterm birth within the Prematurity Research Center at Washington University in St. Louis with negative drug screens (other than cannabis) and without known pregnancy complications or known fetal congenital problems, were invited for participation. N=395 mothers were included in the analysis and N=268 eligible subjects declined participation. N=399 singleton offspring were included.Main Outcome(s) and Measure(s)Birthweight accounting for gestational age.ResultsThe study included N=395 pregnant women and their N=399 singleton offspring. The Social Advantage latent factor significantly predicted the residual birthweight after accounting for gestational age (p=.006) representing a 2.57% increase in residual gestational age-adjusted birthweight for each one standard deviation increase in the Social Advantage. The only other significant predictor was pre-pregnancy BMI (p=.019) which was associated with increased birthweight by gestational age while the Psychosocial Stress factor was no longer significant when other factors were accounted for.Conclusions and RelevanceFindings elucidate the significant effects of social adversity on the developing fetus and underscore the need to protect pregnant women in this risk group.Key PointsQuestion: What are the differential effects of social adversity/advantage and psychosocial stress during pregnancy on fetal development evidenced by birthweight?Findings: Psychosocial adversity/advantage significantly impacted birthweight after accounting for other salient risk factors including maternal physical health.Meaning: Resources and interventions for pregnant women experiencing social adversity should become a public health priority for the protection of the developing fetus.

Partial cortical blindness is a visual deficit caused by unilateral damage to the primary visual cortex, a condition previously considered beyond hopes of rehabilitation. However, recent data demonstrate that patients may recover both simple and global motion discrimination following intensive training in their blind field. The present experiments characterized motion-induced neural activity of cortically blind (CB) subjects prior to the onset of visual rehabilitation. This was done to provide information about visual processing capabilities available to mediate training-induced visual improvements. Visual Evoked Potentials (VEPs) were recorded from two experimental groups consisting of 9 CB subjects and 9 age-matched, visually-intact controls. VEPs were collected following lateralized stimulus presentation to each of the 4 visual field quadrants. VEP waveforms were examined for both stimulus-onset (SO) and motion-onset (MO) related components in postero-lateral electrodes. While stimulus presentation to intact regions of the visual field elicited normal SO-P1, SO-N1, SO-P2 and MO-N2 amplitudes and latencies in contralateral brain regions of CB subjects, these components were not observed contralateral to stimulus presentation in blind quadrants of the visual field. In damaged brain hemispheres, SO-VEPs were only recorded following stimulus presentation to intact visual field quadrants, via inter-hemispheric transfer. MO-VEPs were only recorded from damaged left brain hemispheres, possibly reflecting a native left/right asymmetry in inter-hemispheric connections. The present findings suggest that damaged brain hemispheres contain areas capable of responding to visual stimulation. However, in the absence of training or rehabilitation, these areas only generate detectable VEPs in response to stimulation of the intact hemifield of vision.