You are here

Article Text

Article menu

Download PDFPDF

XML
Neonatology
Original article
Continuum of neurobehaviour and its associations with brain MRI in infants born preterm
  1. Abbey L Eeles1,2,3,
  2. Jennifer M Walsh1,2,4,
  3. Joy E Olsen1,2,5,
  4. Rocco Cuzzilla1,2,5,
  5. Deanne K Thompson1,6,7,
  6. Peter J Anderson1,6,8,
  7. Lex W Doyle1,2,5,6,
  8. Jeanie L Y Cheong1,2,6,
  9. Alicia J Spittle1,2,9
  1. 1 Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  2. 2 Newborn Research, The Royal Women’s Hospital, Melbourne, Victoria, Australia
  3. 3 Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
  4. 4 Paediatric Infant Perinatal Emergency Retrieval (PIPER), The Royal Children’s Hospital, Melbourne, Victoria, Australia
  5. 5 Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
  6. 6 Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
  7. 7 Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
  8. 8 Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia
  9. 9 Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to and Dr Alicia J Spittle; aspittle{at}unimelb.edu.au

Abstract

Background Infants born very preterm (VPT) and moderate-to-late preterm (MLPT) are at increased risk of long-term neurodevelopmental deficits, but how these deficits relate to early neurobehaviour in MLPT children is unclear. The aims of this study were to compare the neurobehavioural performance of infants born across three different gestational age groups: preterm <30 weeks’ gestational age (PT<30); MLPT (32–36 weeks’ gestational age) and term age (≥37 weeks’ gestational age), and explore the relationships between MRI brain abnormalities and neurobehaviour at term-equivalent age.

Methods Neurobehaviour was assessed at term-equivalent age in 149 PT<30, 200 MLPT and 200 term-born infants using the Neonatal Intensive Care UnitNetwork Neurobehavioral Scale (NNNS), the Hammersmith Neonatal Neurological Examination (HNNE) and Prechtl’s Qualitative Assessment of General Movements (GMA). A subset of 110 PT<30 and 198 MLPT infants had concurrent brain MRI.

Results Proportions with abnormal neurobehaviour on the NNNS and the HNNE, and abnormal GMA all increased with decreasing gestational age. Higher brain MRI abnormality scores in some regions were associated with suboptimal neurobehaviour on the NNNS and HNNE. The relationships between brain MRI abnormality scores and suboptimal neurobehaviour were similar in both PT<30 and MLPT infants. The relationship between brain MRI abnormality scores and abnormal GMA was stronger in PT<30 infants.

Conclusions There was a continuum of neurobehaviour across gestational ages. The relationships between brain abnormality scores and suboptimal neurobehaviour provide evidence that neurobehavioural assessments offer insight into the integrity of the developing brain, and may be useful in earlier identification of the highest-risk infants.

  • Neurodevelopment

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjpo-2017-000136

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors ALE collected data, carried out the analyses, drafted the initial manuscript and reviewed and revised the manuscript. JMW collected data, drafted the initial manuscript and reviewed and revised the manuscript. JEO collected data and reviewed and revised the manuscript. RC critically reviewed and revised the manuscript. DKT, PJA, LWD, JLYC and AJS conceptualised and designed the study and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

    • Funding This work was supported in part by the Australian National Health and Medical Research Council (NHMRC) (Project Grant ID 1028822); Centre of Clinical Research Excellence Grant ID 546519; Centre of Research Excellence Grant ID 1060733; Senior Research Fellowship ID 1081288 to PJA; Early Career Fellowship ID 1053787 to JLYC, ID 1053767 to AJS; Career Development Fellowship ID 1108714 to AJS; Australian Postgraduate Scholarship to JEO, Murdoch Children’s Research Institute, Clinical Sciences Theme Grant, the Victorian Government Operational Infrastructure Support Program.

    • Competing interests None declared.

    • Ethics approval The Royal Women’s Hospital Human Research Ethics Board and the Royal Children’s Hospital Human Research Ethics board.

    • Provenance and peer review Not commissioned; externally peer reviewed.