[3670.1] Late Preterm Children Demonstrate Altered Brain Function and Structure at School Age

Jane E. Brumbaugh, Amy L. Conrad, Eric D. Axelson, Peggy C. Nopoulos. Department of Pediatrics, University of Iowa, Iowa City, IA; Department of Psychiatry, University of Iowa, Iowa City, IA.

BACKGROUND: There is emerging evidence of increased sociobehavioral and school-related problems in the late preterm (LPT, 34-36 weeks gestation) population. Altered development of visuospatial perception, memory, or processing speed may underlie these problems. Limited imaging to define the anatomical differences between the LPT and full term (FT) brain has been performed.
OBJECTIVE: To measure cognition, behavior, and brain structure in LPT children compared to FT children at school age.
DESIGN/METHODS: School-aged LPT children (n=32, M=10.46±1.75 y) were recruited from the University of Iowa Neonatal Admissions Registry. Exclusion criteria included neurological injury, multiple gestation, genetic abnormality, birth weight <1500 g, 5-minute Apgar score <7, and neonatal sepsis. FT controls (n=64, M=10.39±2.02 y) were matched 2:1 to LPT children for age and sex. Children completed a battery of assessments, including Wechsler Intelligence Scale for Children, Benton Judgment of Line Orientation, Grooved Pegboard, and Children's Memory Scale. Parents completed a behavioral assessment (Pediatric Behavior Scale-30). Children underwent a 30-minute non-sedated MRI. Analysis in SPSS controlled for age, sex, and intracranial volume (for MRI measures).
RESULTS: LPT children scored lower on perceptual reasoning (p=0.024), visual memory (p=0.004), and visuospatial judgment (p=0.001) than FT children. LPT children also had slower processing speed (p=0.047) in the setting of comparable fine motor skills (p=0.350). LPT boys demonstrated poorer visual learning (p=0.000) but similar auditory learning (p=0.209) to FT boys. Parents of LPT children reported more difficulties in hyperactivity-inattention (p=0.005) and in opposition-aggression (p=0.045). Structural MRI revealed less cerebral white matter (p=0.032), smaller thalami (p=0.001), and smaller hippocampi (p=0.046) in LPT children compared to FT children. Cerebral white matter volume correlated with perceptual reasoning (p=0.041) and visual memory scores (p=0.019).
CONCLUSIONS: LPT children demonstrated worse perceptual reasoning and visual memory compared to FT children. Consistent with previous reports, LPT children had more behavioral difficulties. On MRI, LPT children had less white matter and smaller thalami and hippocampi. Decreased white matter volume may contribute to impaired perceptual reasoning and visual memory. LPT birth affects brain structure and function beyond infancy.


Session: Platform Session: Neonatal Follow Up: Neurodevelopment (3:30 PM - 5:30 PM)
Date/Time: Monday, May 5, 2014 - 3:30 PM
Room: West Ballroom C - Vancouver Convention Centre
Course Code: 3670


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