Regional brain volume abnormalities and long-term cognitive outcome in preterm infants
Abstract
CONTEXT: Preterm infants have a high prevalence of long-term cognitive and behavioral disturbances. However, it is not known whether the stresses associated with premature birth disrupt regionally specific brain maturation or whether abnormalities in brain structure contribute to cognitive deficits. OBJECTIVE: To determine whether regional brain volumes differ between term and preterm children and to examine the association of regional brain volumes in prematurely born children with long-term cognitive outcomes. DESIGN AND SETTING: Case-control study conducted in 1998 and 1999 at 2 US university medical schools. PARTICIPANTS: A consecutive sample of 25 eight-year-old preterm children recruited from a longitudinal follow-up study of preterm infants and 39 term control children who were recruited from the community and who were comparable with the preterm children in age, sex, maternal education, and minority status. MAIN OUTCOME MEASURES: Volumes of cortical subdivisions, ventricular system, cerebellum, basal ganglia, corpus callosum, amygdala, and hippocampus, derived from structural magnetic resonance imaging scans and compared between preterm and term children; correlations of regional brain volumes with cognitive measures (at age 8 years) and perinatal variables among preterm children. RESULTS: Regional cortical volumes were significantly smaller in the preterm children, most prominently in sensorimotor regions (difference: left, 14.6%; right, 14.3% [P<.001 for both]) but also in premotor (left, 11.2%; right, 12.6% [P<.001 for both]), midtemporal (left, 7.4% [P =.01]; right, 10.2% [P<.001]), parieto-occipital (left, 7.9% [P =.01]; right, 7.4% [P =.005]), and subgenual (left, 8.9% [P =.03]; right, 11.7% [P =.01]) cortices. Preterm children's brain volumes were significantly larger (by 105. 7%-271.6%) in the occipital and temporal horns of the ventricles (P<. 001 for all) and smaller in the cerebellum (6.7%; P =.02), basal ganglia (11.4%-13.8%; P</=.005), amygdala (left, 20.2% [P =.001]; right, 30.0% [P<.001]), hippocampus (left, 16.0% [P =.001]; right, 12.0% [P =.007]), and corpus callosum (13.1%-35.2%; P</=.01 for all). Volumes of sensorimotor and midtemporal cortices were associated positively with full-scale, verbal, and performance IQ scores (P<.01 for all). CONCLUSIONS: Our data indicate that preterm birth is associated with regionally specific, long-term reductions in brain volume and that morphological abnormalities are, in turn, associated with poorer cognitive outcome. JAMA. 2000;284:1939-1947.
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In humans, low birth weight and preterm birth are linked to regional brain volume changes.
“Thus, low birth weight as well as preterm birth have been related to changes in regional brain volumes (e.g. Peterson et al., 2000; Abernethy et al., 2002; Nosarti et al., 2002; Huizink et al., 2004; Buss et al., 2007; Beauchamp et al., 2008).”
From High pregnancy anxiety during mid-gestation is associated with decreased gray matter density in 6-9-year-old children. (2010) · cites this paper as Peterson et al., 2000
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- Authors
- Peterson, B. S.
- Affiliations
- Yale University (US)
- Corresponding author
- Peterson, Bradley S.
- ORCID
- Peterson, Bradley S.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2000-10-18
- Volume
- 284
- Issue
- 15
- Pages
- 1939
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2144966005
- Cited by
- 981
- References
- 49
- Citations by year
- 2026: 12 · 2025: 15 · 2024: 19 · 2023: 26 · 2022: 16 · 2021: 34 · 2020: 26 · 2019: 37 · 2018: 33 · 2017: 45 · 2016: 27 · 2015: 42 · 2014: 52 · 2013: 53 · 2012: 56
- FWCI
- 28.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (NS-35476, NS-27116, R01NS027116, P01NS035476)
- National Center for Research Resources (RR06022)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Keywords
- preterm infants, regional brain volume, long-term cognitive outcomes, brain maturation, cortical volume, ventriculomegaly, cerebellum, basal ganglia, amygdala, hippocampus, corpus callosum, sensorimotor cortex, perinatal risk factors, term versus preterm comparison, child cognitive development, neurodevelopmental outcome prediction
- MeSH terms
- Brain, Child, Developmental Disabilities, Cognition, Female, Humans, Infant, Newborn, Infant, Premature, Intelligence, Longitudinal Studies, Magnetic Resonance Imaging, Male, Psychological Tests, Multivariate Analysis, Case-Control Studies
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