The Life Course Consequences of Very Preterm Birth

Wolke, Dieter; Johnson, Samantha; Mendonça, Marina

doi:10.1146/annurev-devpsych-121318-084804

Cited by 95 publications

(90 citation statements)

References 158 publications

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“…During the second and third trimesters of pregnancy, there is a phase of rapid brain maturation characterised by volumetric growth, increases in cortical complexity, white matter organization and myelination [1]. Early exposure to extrauterine life due to preterm birth affects around 11% of births, and is closely associated with neurodevelopmental, cognitive and psychiatric impairment [2,3,4], and alterations to development [5] that are apparent using in vivo imaging techniques. At the macro scale, these alterations can be characterised by charting white matter connections between brain regions using diffusion MRI (dMRI) [6,7,8,9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Hierarchical complexity of the macro-scale neonatal brain

Blesa

Galdi

Cox³

et al. 2020

Preprint

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The human adult structural connectome has a rich topology composed of nodal hierarchies containing highly diverse connectivity patterns, aligned to the diverse range of functional specialisations in the brain. The emergence of this hierarchical complexity in human development is unknown. Here, we substantiate the hierarchical tiers and complexity of brain networks in the newborn period, assess correspondences with hierarchical complexity in adulthood, and investigate the effect of preterm birth, a leading cause of neurocognitive impairment and atypical brain development, on hierarchical complexity. We report that the neonatal and adult structural connectomes are both composed of distinct hierarchical tiers. Consistency of ROIs is found at both ends of this hierarchy during early life and in adulthood, but significant differences are evident in intermediate tiers. The neonatal connectome is hierarchically complex in term born neonates, but hierarchically complexity is altered in association with preterm birth. This is mainly due to diversity of connectivity patterns in Tier 3, which is comprised of regions that underlie sensorimotor processing and its integration with cognitive information. For neonates and adults, the highest tier (comprising hub regions) is ordered, rather than complex, with more homogeneous connectivity patterns in structural hubs. This suggests that the brain develops first a more rigid hierarchical structure in hub regions allowing for the development of greater and more diverse functional specialisation in lower level regions, while connectivity underpinning this diversity is dysmature in infants born preterm.

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Section: Introductionmentioning

confidence: 99%

Hierarchical complexity of the macro-scale neonatal brain

Blesa

Galdi

Cox³

et al. 2020

Preprint

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“…In addition to the computation of frequencies and group differences, the relative risk (RR) with 95% confidence interval (CI) was calculated to test whether VP/VLBW individuals more often had a trajectory of high degree of motor difficulties in early childhood (reference: low degree of motor difficulties) compared to term-born participants. RR was subsequently adjusted for potential confounds of motor outcomes [9], such as SGA, multiple births, child sex, family SES at birth, and IQ at 56 months.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Both motor and cognitive impairments can have a profound impact on learning, academic achievement, health, and wellbeing across the lifespan for VP/VLBW individuals [3,4], and may persist throughout childhood and into adulthood [5][6][7][8]. Furthermore, they are the two most frequent sequelae of VP/VLBW [9].…”

Section: Introductionmentioning

confidence: 99%

Early Motor Trajectories Predict Motor but not Cognitive Function in Preterm- and Term-Born Adults without Pre-existing Neurological Conditions

Baumann

Tresilian

Bartmann

et al. 2020

IJERPH

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Very preterm (VP; <32 weeks gestation) and/or very low birth weight (VLBW; <1500 g) birth has been associated with an increased risk of adverse motor and cognitive outcomes that may persist into adulthood. The aim of this study was to determine whether motor development in the first five years of life is associated with motor and cognitive outcomes in adulthood. A prospective observational study in Germany followed 260 VP/VLBW and 229 term-born individuals from birth into adulthood. Early motor trajectories (i.e., high and low degree of motor difficulties) were determined from neurological examinations from birth to 56 months. Adult motor and cognitive outcomes were determined from information from multiple instruments and IQ tests, respectively. Associations of VP/VLBW birth and early motor difficulties on adult outcomes were assessed using regression analyses. VP/VLBW individuals had an increased risk for early motor difficulties (Relative Risk: 11.77, 95% confidence interval (CI): 4.28, 32.35). Early motor difficulties were associated with poorer motor competence in adulthood (β = 0.22, p < 0.001), independent of VP/VLBW birth. Adult IQ was predicted by VP/VLBW (β = −0.12, p < 0.05) and child IQ (β = 0.51, p < 0.001), while early motor difficulties ceased to be associated with adult IQ once participants with a neurological impairment were excluded (β = 0.02, p > 0.05). Motor problems in childhood were homotypically associated with poorer motor competence in adulthood. Similarly, early cognitive problems were homotypically associated with adult cognitive outcomes. Thus, both motor and cognitive function should be assessed in routine follow-up during childhood.

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“…These deficits persist into adulthood (Breeman, Jaekel, Baumann, Bartmann, & Wolke, 2015). Wolke, Johnson, and Mendonça (2019) reviewed cognitive outcomes after very preterm (VP) birth and concluded that low IQ is one of the major sequelae of VP birth.…”

Section: Introductionmentioning

confidence: 99%

Decreased cortical thickness mediates the relationship between premature birth and cognitive performance in adulthood

Schmitz‐Koep

Bäuml

Menegaux

et al. 2020

Human Brain Mapping

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Cortical thickness (CTh) reflects cortical properties such as dendritic complexity and synaptic density, which are not only vulnerable to developmental disturbances caused by premature birth but also highly relevant for cognitive performance. We tested the hypotheses whether CTh in young adults is altered after premature birth and whether these aberrations are relevant for general cognitive abilities. We investigated CTh based on brain structural magnetic resonance imaging and surface‐based morphometry in a large and prospectively collected cohort of 101 very premature‐born adults (<32 weeks of gestation and/or birth weight [BW] below 1,500 g) and 111 full‐term controls at 26 years of age. Cognitive performance was assessed by full‐scale intelligence quotient (IQ) using the Wechsler Adult Intelligence Scale. CTh was reduced in frontal, parietal, and temporal associative cortices predominantly in the left hemisphere in premature‐born adults compared to controls. We found a significant positive association of CTh with both gestational age and BW, particularly in the left hemisphere, and a significant negative association between CTh and intensity of neonatal treatment within limited regions bilaterally. Full‐scale IQ and CTh in the left hemisphere were positively correlated. Furthermore, CTh in the left hemisphere acted as a mediator on the association between premature birth and full‐scale IQ. Results provide evidence that premature born adults have widespread reduced CTh that is relevant for their general cognitive performance. Data suggest lasting reductions in cortical microstructure subserving CTh after premature birth.

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The Life Course Consequences of Very Preterm Birth

Cited by 95 publications

References 158 publications

Hierarchical complexity of the macro-scale neonatal brain

Hierarchical complexity of the macro-scale neonatal brain

Early Motor Trajectories Predict Motor but not Cognitive Function in Preterm- and Term-Born Adults without Pre-existing Neurological Conditions

Decreased cortical thickness mediates the relationship between premature birth and cognitive performance in adulthood

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